We’ve made our guidelines for billing Medicare outpatient therapy service easier for you

You’re no longer required to submit all medical records when your claims are equal to, or exceed, $3000 for Medicare outpatient therapy services. Instead, you’ll be notified if chosen for a targeted medical record review.

What’s changing

We’ve heard you and changed our process to decrease administrative burden on you and your practice. You’re no longer required to submit medical records for Medicare outpatient therapy claims greater than, or equal to, $3000. The new process will still require the KX modifier as a confirmation that services are medically necessary.

Instead of submitting medical records with your claims, we’ll notify you if you are chosen for the review.