Humana Requires CQ/CO Modifiers Effective January 1, 2020

Humana Requires CQ/CO Modifiers Effective January 1, 2020

Humana has published a Claims Payment Policy dated December 2019 that addresses the use of the therapist assistant modifiers, CQ and CO, with its Medicare Advantage and Commercial products. Per the policy, Humana requires the CQ and CO modifiers, indicating services provided in whole or in part by a PTA or OTA, appended to all charges provided with dates of service January 1, 2020 or later.  In addition, effective with dates of service beginning January 1, 2022, Humana will allow a charge for an outpatient PTA or OTA service at 85% of the contracted rate or base maximum amount payable under the member’s plan.

For more information, access the policy here.

Holly Hester

Holly Hester is Casamba’s Senior Vice President of Compliance & Education, as well as the Compliance Officer. She provides regulatory guidance and interpretation, clinical programming and content development, education and training steerage, and compliance support for the company. As a physical therapist for more than 20 years, Holly has multi-venue clinical and management experience, giving her a unique perspective on the integration of compliance and training with therapy service delivery and clinical practice.
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