December 4, 2025
The following policies received their annual review with no changes:
The following policies received their annual review with changes noted below:
Medicare Status B/P/T
- Removed cross reference to personal protective equipment (PPE) policy archived October 7, 2025.
- In the policy section, removed the effective date for Status P codes.
- In the coding section, removed the effective date for code G2211.
- In the coding section, removed the Status Indicator B effective date for current procedural terminology (CPT) 99072.
Physical Therapy (PT)- Occupational Therapy (OT)- Speech Therapy (ST) Therapy Services
- Added a clarifying time statement to the policy section:
- “When calculating the number of billable units for a particular date of service, add the total minutes of skilled, one-on-one therapy and divide that total by 15. If eight or more minutes are left over, bill for one more unit; if seven or
fewer minutes remain, an additional unit is not supported. The total billed therapy units must be supported by the documented total time spent on therapeutic activities.”
Anesthesia Guidelines
- Added a reimbursement statement for modifier QZ within the policy section:
- “Effective dates of service on and after March 6, 2026, reimbursement will change from 100% to 85% of the provider’s applicable fee schedule allowed amount.”