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Blog: Therapy Edits Reversed!

In response to a massive advocacy campaign, CMS made the decision to delete limiting edits that were put in place 1/1/2020. As a result, therapeutic activities (97530) and group (97150) codes are now able to be used again for treatment on the same dates as PT and OT evaluations allowing clinicians the freedom to initiate patient care delivery without delay.

Please see below an excerpt from Capitol Bridge NCCI Contractor for CMS that was published Friday Jan 24, 2020.

“After reviewing this issue more closely, CMS has made the decision to retain the edits that were in effect prior to January 1, 2020 and to delete the following January1, 2020 PTP edits:”

Column 1:

97530

97530

97530

97530

97530

97530

97150

97150

97150

97150

97150

97150

Column 2:

97161

97162

97163

97165

97166

97167

97161

97162

97163

97165

97166

97167

“You may notify your members of these edit changes. CMS will provide further information when it becomes available regarding impacted claims.”

Let’s Get to the Point:

PT’s and OT’s are now able to eval and utilize treatment including therapeutic activities and group on the same day as clinically indicated. Advocacy is truly impactful!

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