Are you a NY (Physical Therapy/Occupational Therapy) provider that accepts EmblemHealth Commercial Plan members? Then this blog post is for you!

Don’t leave revenue on the table – make sure you get reimbursed in timely manner for your services!

Are you using the proper modifiers?

• For PT/OT- defined as Rehabilitative medicine- make sure you are using the proper modifiers to receive the reimbursement
• Main modifier- 97 for rehabilitative services- PT/O
• Additional Modifiers info-for any service that is considered “always therapy” please also use additional modifiers: GO’ for occupational therapy, and/or GP’ for physical therapy when applicable.

Removed codes under the policy:

• 92596, 97151, 97158,

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