Submitting claims for habilitative and rehabilitative services? Read this before you do

December 22, 2017 -

Beginning Jan. 1, 2018 and moving forward, you should bill the following modifiers along with the procedure code when submitting claims for habilitative and rehabilitative services.

 Rehabilitative Services Modifier Code Description
96
Habilitative services
97 Rehabilitative services

The 'SZ' modifier should only be added to claims for Habilitative services through Dec. 31, 2017.

To view the medical policies associated with these services, please refer to the Medical Policy Reference Manual at www.carefirst.com/medicalpolicy.

Updates to Four Provider Forms

Four provider forms have been updated to include a reminder for using these new modifier codes when submitting claims:

Forms can also be found by visiting www.carefirst.com/providerforms.