The Centers for Medicare and Medicaid Services (CMS) has issued a notice regarding the 59 modifier in reimbursement claims. A news release from the American Physical Therapy Association (APTA) notes that CMS has advised healthcare professionals to continue using, until further notice, the 59 modifier in reimbursement claims to indicate that a health care common procedural code (HCPCS) represents a service that is separate and distinct from another service to which it is paired under the Correct Coding Initiative (CCI) program.
The APTA news release indicates that the clarification was forwarded to APTA by CMS after some physical therapists asked whether they should begin using the new modifiers. The basic answer from CMS is “not yet.”
In August, CMS issued a transmittal describing new modifiers—XE, XS, XP, and XU—intended to be used to define subsets of the 59 modifier, according to the APTA news release. The new modifier codes have not been implemented, and CMS has advised that physical therapists should not use the modifiers until they receive further notice.