In accordance with The Centers for Medicare & Medicaid Services (CMS), the Company has established claims processing guidelines for multiple physical, occupational, and speech therapy services that are designated as Always Therapy.
CMS designates certain procedure codes as Always Therapy. Such procedure codes are assigned a therapy disposition code of "5" by CMS. These codes always represent therapy services when rendered by therapists or by practitioners who are not therapists in situations where the service provided is integral to an outpatient rehabilitation therapy plan of care. For these situations, these codes must always have a therapy modifier.