In October 2018, Cigna Government Services (CGS), Medicare Administrative Contractor for the states of Kentucky and Ohio, will begin the CGS Targeted Probe and Education (TPE) program and will begin review of claims associated with physical and occupational therapies provided in the private practice setting, both therapist owned and physician owned.
CPT codes initially under review will include:
- 97110- Therapeutic procedure, 1 or more areas, each 15 minutes; therapeutic exercises to develop strength and endurance, range of motion and flexibility
- 97112-Neuromuscular re-education of movement, balance, coordination, kinesthetic sense, posture, and/or proprioception for sitting and/or standing activities
- 97113-Aquatic therapy with therapeutic exercises
- 97116-Gait Training Therapy (includes stair climbing)
- 97140-Manual therapy techniques (eg mobilization/manipulation, manual lymphatic drainage, manual traction) to 1 or more regions, each 15 minutes
- 97530- Therapeutic activities, direct (one-on-one) patient contact (use of dynamic activities to improve functional performance), each 15 minutes
For more information on the CGS Targeted Probe and Education, click HERE.