by Wyn Staheli, Director of Research
January 31st, 2018
According to a publication from Medicare which came from the FAQ page for physical therapy services, the following information (in italics below with emphasis added) indicates that it is appropriate to perform them at the same time and that they are not requiring a modifier. However, this information is from Medicare, different payers may have different policies so be sure to verify coverage with individual payers.
2. Billing - CPT Codes: Permitted
In the same 15-minute time period, one therapist may bill for more than one therapy service occurring in the same 15-minute time period where "supervised modalities" are defined by CPT as untimed and unattended -- not requiring the presence of the therapist (CPT codes 97010-97028). One or more supervised modalities may be billed in the same 15-minute time period with any other CPT code, timed or untimed, requiring constant attendance or direct one-on-one patient contact. However, any actual time the therapist uses to attend one-on-one to a patient receiving a supervised modality cannot be counted for any other service provided by the therapist.
4. CPT Definitions: CPT 2004, American Medical Association Press
5. Counting of timed codes: Claims Processing Manual, 100-04, Chapter 5, Section 20.3, and Program Memorandum AB-01-68 (May 1, 2001)