Physical Therapy Billing G Codes Made Easy!

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Physical Therapy Billing G Codes Made Easy!

Medicare Will Require G-Codes and C-Modifiers be Included on the Claim

All physical therapy billing, as well as occupational therapy and speech therapy billing, will have to include functional reporting G codes and C modifiers on the claims or they will get denied beginning July 1, 2013.  Don’t worry, the new requirements are not that difficult to implement.  And these efforts are for the purpose of moving away from the faulty Medicare “Cap” system currently in place.  This article will explain how to make the billing of physical therapy G codes easy!

Where do these “G Codes” (and C modifiers) Go on the HCFA Form?

It might be best to start by showing you exactly where these new G codes will go on the claim form.  See pic below.

physical therapy billing g codes
Where the codes go

Highlights (refer to the pic above of a physical therapy billing claim):

  1. The G codes go in the same column as your CPT codes but do not carry with it any charges.
  2. The C modifier goes into one of the four “modifiers” column.
  3. Remember to always add the “GP” modifier even to these functional non-payable codes.

I will explain how you determine which G code or C modifier to use in a moment.  I wanted to first have you see where these codes actually go.

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 That’s G codes physical therapy billing made easy!

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