Wednesday, July 7, 2010

PROCEDURE CODES THAT MAY BE BILLED WITH THE "TM" MODIFIER

PROCEDURE CODES THAT MAY BE BILLED WITH THE "TM" MODIFIER


 Procedure Code    Description    Allowed Amount    per Unit  
 92506    Speech/Hearing Evaluation    $10    per unit  
 92507    Speech/Hearing Therapy - Individual    $10    per unit  
 92508    Speech/Hearing Therapy - Group    $3    per unit per student  
 97001    PT Evaluation    $10    per unit  
 97002    PT Re-evaluation    $10    per unit  
 97003    OT Evaluation    $10    per unit  
 97004    OT Re-evaluation    $10    per unit  
 97012    Mechanical Traction Therapy    $10    per unit  
 97014    Electric Stimulation therapy    $10    per unit  
 97016    Vasopneumatic Device Therapy    $10    per unit  
 97018    Paraffin Bath Therapy    $10    per unit  
 97020    Microwave Therapy    $10    per unit  
 97022    Whirlpool Therapy    $10    per unit  
 97024    Diathermy Treatment    $10    per unit  
 97026    Infrared Therapy    $10    per unit  
 97028    Ultraviolet Therapy    $10    per unit  
 97032    Electrical Stimulation    $10    per unit  
 97033    Electric Current Therapy    $10    per unit  
 97034    Contract Bath Therapy    $10    per unit  
 97035    Ultrasound Therapy    $10    per unit  
 97036    Hydrotherapy    $10    per unit  
 97110    Therapeutic Exercises    $10    per unit  
 97112    Neuromuscular Re-Education    $10    per unit  
 97113    Aquatic Therapy    $10    per unit  
 97116    Gait Training Therapy    $10    per unit  
 97124    Massage Therapy    $10    per unit  
 97140    Manual Therapy    $10    per unit  
 97504    Orthotic Training    $10    per unit  
 97520    Prosthetic Training    $10    per unit  
 97530    Therapeutic Activities    $10    per unit  
 97532    Cognitive Skills Development    $10    per unit  
 97533    Sensory Integration    $10    per unit  
 97535    Self Care Management Training    $10    per unit  
 97542    Wheelchair Management Training    $10    per unit  
 97750    Physical Performance Test    $10    per unit  




* 1 unit = 15 minutes of therapy

* Services provided by a speech implementer, OT, or PT assistant may not be billed to Medicaid
* Only SP therapy may be billed as a group therapy. A group consists of 2 or more, but less than 8.
The group may be both Medicaid and non-Medicaid eligible students.

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