Are you aware modifier GP is being adopted by additional carriers as a requirement for reimbursement of…
Welcome to your billing and coding weekly solutions by American Acupuncture Council Network (AAC).
Are you aware modifier GP is being adopted by additional carriers as a requirement for reimbursement of physical medicine services?
This therapy modifier is required by United Health and its affiliates since 2020. The modifier GP is also required for VA claims and Medicare and Medicare Advantage plans.
More carriers are starting to require its use including Blue Cross Blue Shield of Michigan, Blue Cross of California (For California providers this does not include Blue Shield of California), and now also by BCBS plans of Indiana, Kentucky, Missouri, New Jersey, Ohio, Vermont, and Wisconsin.
All physical medicine codes 97010 through 97799 (PT codes) must be appended with a GP or denied as missing or incomplete.
If you get a denial indicating a missing modifier on a physical medicine code, the modifier GP may be the likely fix.
Remember, billing with incorrect acupuncture CPT and ICD codes can lead to claim rejections and delays in payments, which can have a devastating impact on generating revenue and keeping you in business.
If you are experiencing insurance claim denial, staff spending too much time trying to get claims paid, and patients asking why their claims have not been paid then American Acupuncture Council Network is your solution.
American Acupuncture Council Network stays ahead of the curve on the latest trends and changes in billing and coding utilizing their direct channel of communication with the insurance companies and organizations that set the guidelines.
There is a reason acupuncturists have trusted AAC with their business for over 30 years.