Does the New PO Modifier Apply to Outpatient Therapy Services?

February 1, 2016
 / 
Rick Gawenda
 / 

In the CY 2015 Outpatient Prospective Payment System Final Rule, the Centers for Medicare and Medicaid Services (CMS) created a HCPCS modifier for hospital claims that is to be reported with every code for outpatient hospital items and services furnished in an off-campus provider-based department (PBD) of a hospital. Reporting of this new modifier was voluntary for CY 2015, with reporting required beginning on January 1, 2016.

I am often asked must off-campus therapy locations that are hospital based departments (i.e. billing under the hospital NPI number) use the PO modifier on all CPT codes submitted on the UB-04 claim form for outpatient physical, occupational and speech therapy services? The answer to the question is

The content here is for members only log in here or sign up.


All material posted on our website is the intellectual property of Gawenda Seminars & Consulting, Inc. and can’t be used, reproduced, or posted as your own material without the prior written approval of Gawenda Seminars & Consulting, Inc.

This article is not intended to and does not serve as legal advice or as consultative services, but is for general information purposes only.

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.