Skip to main content

In passing the Bipartisan Budget Act of 2018, Congress required that by January 1, 2019, the Centers for Medicare and Medicaid Services establish a modifier to indicate when an outpatient physical therapy service is furnished in whole or in part by a physical therapist assistant.

Starting January 1, 2022, outpatient physical therapy services covered under the Medicare physician fee schedule that are furnished at least in part by a PTA will be paid at 85% of the applicable fee schedule rate. (A similar modifier was designated for services provided by an occupational therapy assistant, which also will be subject to the 85% payment differential).

So that providers are prepared for 2022, use of the modifier was mandated as of January 1, 2020, for outpatient therapy providers across almost all settings — including private practices, skilled nursing facilities, home health agencies, outpatient hospitals, rehabilitation agencies, and comprehensive outpatient rehabilitation facilities. The modifier is CQ for PTAs (CO for OTAs).

Log in or create a free account to keep reading.


Join APTA to get unlimited access to content.


You Might Also Like...

News

APTA-Backed Bipartisan Legislation Aims to Help PTs Avoid Interruptions in Care

Mar 20, 2023

If enacted, PTs across the country would be allowed to secure substitute care for patients during an absence.

Roundup

Brain Injury Care: 3 APTA Resources to Help You Advance Your Knowledge

Mar 20, 2023

PTs and PTAs have an important role to play. Here's how you can learn, explore, and connect during Brain Injury Awareness Month.

Roundup

The Good Stuff: Members and the Profession in the Media, March 2023

Mar 15, 2023

APTA members providing insight on everything from communicating about developmental delays to assisted stretching.