Therapy payment caps and exception process

The Financial Limitation Legislation A. Legislation on Limitations The dollar amount of the limitations (caps) on outpatient therapy services is established by statute. The updated amount of the caps is released annually via Recurring Update Notifications and posted...

CPT code 99173, 99174 , 99183, 99199

Procedure code and Description 99173 Screening test of visual acuity, quantitative, bilateral. 99174 Instrument-based ocular screening 99199 – Unlisted special service, procedure or report 99183 – Physician attendance and supervision of hyperbaric oxygen...

Modifier 25 and E & M services

Multiple E&M services on the same day • Reimbursement will be made for a preventive code with a problem focused code when modifier -25 is applied to the problem-focused code. Reimbursement for the preventive  service will be made at 100% of the contracted...