Getting paid: Report Medicare G codes and modifiers to ensure therapy evaluation pay

Why This Topic Matters

Understanding the reporting categories and CMS implementation dates helps providers avoid claim denials or returned claims for therapy evaluation services under Medicare.

Article Sections

1. Therapy evaluation reporting under Medicare

   Overview of the Medicare claim-reporting context for therapy evaluation services and the CMS guidance discussed in the article.

2. Therapy modifiers for evaluation codes

   Discussion of the therapy modifier requirements associated with the new therapy evaluation and re-evaluation code families.

3. Functional limitation G codes and severity modifiers

   Coverage of the additional Medicare reporting categories tied to therapy evaluation claims and how they relate to functional status reporting.

4. Implementation timing and claims edits

   Summary of the rollout schedule for Medicare claims processing changes and when different screening and edit processes were to take effect.

5. Resources

   Links to the referenced CMS transmittals and related MLN material.