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.
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:
- Durable Durable Medical Equipment (DME) Prosthetics and Orthotics
- Home Care Pre-Authorization
- Home Care Extension
- Outpatient Pre-Treatment Authorization Program (OPAP)
Forms can also be found by visiting www.carefirst.com/providerforms.