Reminder: Bill outpatient rehab services per our payment policy
June 3, 2022
This article is for acute care facilities caring for our members
Blue Cross reimburses for outpatient rehabilitation services as outlined in our existing Outpatient Rehabilitation Services payment policy.
As a reminder, we reimburse:
- Initial evaluation for physical or occupational therapy
- Physical therapy treatment with one rate that includes all modalities rendered, per member, per date of service
- Both the initial evaluation and therapy treatments rendered on the same day for the same member by the same provider
- Occupational therapy treatment with one rate that includes all modalities rendered, per member, per date of service
- Speech therapy treatment
We do not reimburse:
- Dry hydrotherapy
Billing information
| Revenue codes | Description | Comments |
|---|---|---|
| 0421 | Physical therapy – visit charge | Bill one unit of service, regardless of the number of modalities rendered, with the sum of all applicable charges. Reimbursable with the initial evaluation if it occurs on the same day as the treatment. |
| 0424 | Physical therapy – evaluation or reevaluation | |
| 0431 | Occupational therapy – visit charge | Bill one unit of service, regardless of the number of modalities rendered, with the sum of all applicable charges. Reimbursable with the initial evaluation if it occurs on the same day as the treatment. |
| 0434 | Occupational therapy – evaluation or reevaluation |
See our payment policy for additional reimbursement and billing guidelines.
Questions?
Call Provider Service at 1-800-882-2060. As always, thank you for the care you provide to your patients—our members.
Resources
Outpatient Rehabilitation Services payment policy (log in and go to Office Resources>Policies & Guidelines>Payment Policies)
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