OLTL Issues Billing Clarification for Cog Rehab Therapy

The Office of Long-Term Living (OLTL) issued a billing clarification for Cognitive Rehabilitation Therapy (CRT) Procedure Code 97127 SE.

This procedure code can be billed by either billing each date of service separately per claim or by billing each date of service on separate detail lines of a date spanned claim.

Examples:

Billing each date of service separately per claim:

Would mean billing each date of service for each recipient for this procedure code individually. Each date is recognized as a new claim and will have a different ICN.

Billing each date of service on separate detail lines of a date spanned claim:

Would mean span dating the dates of service from one date to another date. At the bottom of the claims each date of service is a different line or number. This will show each day on a different line in the detail section of the claim.

Providers should continue to use the SE modifier per the OLTL fee schedule.

Questions regarding this clarification should be directed to the OLTL Provider Inquiry Unit via email or 800-932-0939.