Billing Reminder! CMS 2019 Physician Fee Schedule Final Rule Is Now In Effect!
Physician Fee Schedule Effective January 1, 2019
CMS released the Physician Fee Schedule Final Rule in November 2018 with an effective date of January 1, 2019
What you need to know
Functional Limitations (G Coding)As of January 1st, entering of G codes on Medicare B claims is no longer required. However, we have instructed our rehab teams to continue to enter them for any Managed Care provider that requires them unless notified otherwise.
KX Modifier / Threshold
Although CMS repealed the therapy cap in 2018, CMS continues to require a KX modifier be applied to services over the threshold amounts, which for 2019 are as follows: $2040 for PT and ST combined, and $2040 for OT. Our billing exports will continue to include the KX modifier
The fee schedule rates were increased by .11% in aggregate; reimbursement for some codes increased, some decreased. Please verify that your software has been updated accordingly
New Assistant Modifiers
CMS created new modifiers to be entered on claims for Med B beginning
If you have any questions, please contact: Maria Maggi, Vice President of Compliance at email@example.com.