Due to the Bipartisan Budget Act of 2018, the Centers for Medicare and Medicaid Services (CMS) implemented the CQ and CO modifiers to be appended to CPT codes on the claim form when those services are provided in whole or in part by a physical therapist assistant (PTA) and occupational therapy assistant (OTA), respectively. This requirements began in calendar year 2020 and for calendar years 2020 and 2021, the application of these modifiers to CPT codes on the claim form have no financial implication on the payment for outpatient therapy services. Beginning for dates of service on and after January

Effective with dates of service on and after April 16, 2020, TRICARE recognizes physical therapist assistants (PTAs) and occupational therapy assistants (OTAs) as TRICARE-Authorized Providers. On April 22, 2020, TRICARE updated their Policy Manual to include PTAs and OTAs. Highlights of the Policy Manual update include the following: Scope of practice of a PTA and OTA Supervision requirements of the PTA and OTA based on practice setting Reimbursement for services provided by a PTA or OTA Application of the CQ and CO modifier when services are provided in whole or in part by a PTA or OTA, respectively Payment differential