Posted in MVP (NY/VT) Insurance Payer, Training, Updates

MVP Medicare Patients-KX modifier

If you are a physician that provides PT/OT/ST services to MVP Medicare Patients, then this blog post is for you!

KX modifier should NOT be used when the member did not exhaust that member’s PT/OT/ST benefits.

Claims that require a therapy cap exception and are billed with the KX modifier must:
• Qualify for the therapy cap exception
• Be medically reasonable and necessary services that require the skills of a therapist
Be justified by appropriate documentation in the medical records and would be available for review upon request

Providers: Please log on to the MVP website and verify member benefits to see that member met their annual PT/OT/ST visit cap.

If you find this type of information useful? Follow my blog for more medical billing and coding guidelines, medical policy/reimbursement policy changes and anything else healthcare related.

Recent Blog Posts:

#physicaltherapy, #occupationaltherapy #MVP #MVPmedicare #medicalbilling #medicalcoding



My name is Kate Patskovska, CPB. I am an Independent Medical Biller CPB (AAPC) and an owner of KR2 Medical Billing. KR2 Medical Billing is a full service Consulting/Medical Billing Business that is dedicated to educating, consulting, and overall improving the "financial health" of your medical practice.

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