Reminder: Billing for physical, occupational and speech therapy

Blue Cross Blue Shield of Michigan has been receiving calls from hospitals that some PT, OT and ST claims are rejecting due to benefit maximum limits being reached. These claims may reach benefit maximum limits too early because of incorrect billing. If a date span is billed, rather than the individual dates of service, visit counts will be higher than they should be. Date spans should not be billed for PT, OT or ST claims.

For dates of service of Oct. 1, 2013, and later, hospital outpatient departments and freestanding OPTs were instructed to bill a separate revenue line reporting the revenue code and corresponding HCPCS code for each date of service a patient received a PT, OT or ST service. Billing instructions and examples were provided in the July 2013 issue of The Record. These instructions and claim examples are also in the “Claims” chapter of the hospital outpatient and freestanding OPT provider manuals.