06/22/15
Can I Use the KX Modifier Above $3700?
I am often asked by therapists, office managers, biller’s, billing companies, etc., if the application of the KX modifier is allowed for Medicare beneficiaries who have exceeded $3700 physical and speech therapy combined in a calendar year or a separate $3700 for occupational therapy in a calendar year. Providers of therapy services are under the impression that Medicare beneficiaries have 2 therapy caps, one at $1940 in calendar year 2015 and a second therapy cap at $3700. Providers are also under the impression that once a Medicare beneficiary exceeds $3700, the KX modifier is no longer allowed to be applied
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