Arkansas Administrative Code
Agency 016 - DEPARTMENT OF HUMAN SERVICES
Division 06 - Medical Services
Rule 016.06.05-087 - Home Health Provider Manual Update Transmittal #70; Hospital/Critical Access Hospital (CAH)/End-Stage Renal Disease (ESRD) Provider Manual Update Transmittal #70; Rehabilitative Hospital Provider Manual Update Transmittal #54

Universal Citation: AR Admin Rules 016.06.05-087

Current through Register Vol. 49, No. 9, September, 2024

Section II Home Health

242.120 Home Health Physical Therapy

Procedure Code	Modifier	Description
97110	UB	Home Health Physical Therapy by a Qualified Physical Therapy Assistant
97110	Home Health Physical Therapy by a Qualified Licensed Physical Therapist

Section II

Hospital/Critical Access Hospital (CAH)/End Stage Renal Disease (ESRD)

272.132 Procedure Codes Requiring Modifiers

Procedure Code	Modifier	Description
T1015	U1	Outpatient Hospital Clinic Room Charge. This room charge includes supplies and non-physician staffing.
77417	U1	Therapeutic Radiology Port Film(s)
77417	U2	Therapeutic Radiology Port Film(s)
77417	U3	Therapeutic Radiology Port Film(s)
92507	UB	Individual Speech Therapy by SLPA
92508	UB	Group Speech Therapy by SLPA
97110	UB	Individual Physical Therapy by Physical Therapy Assistant
97150	U1, UB	Group Occupational Therapy by Occupational Therapy Assistant
97150	UB	Group Physical Therapy by Physical Therapy Assistant
97530	UB	Individual Occupational Therapy by Occupational Therapy Assistant
99401	UA	Outpatient Hospital Clinic Room Charge?Periodic Family Planning Visit
99402	UA	Outpatient Hospital Clinic Room Charge?Basic Family Planning Visit

Section II

Rehabilitative Hospital

242.122 Procedure Codes Requiring Modifiers

Treatment and therapy procedure codes may not be billed in conjunction with revenue code T1015. Medicaid reimbursement for a treatment/therapy room is included in the therapy reimbursement.

Procedure Code	Modifier	Description
T1015	U1	Outpatient Hospital Clinic Room Charge. This room charge includes supplies and non-physician staffing.
92507	UB	Individual Speech Therapy by SLPA
92508	UB	Group Speech Therapy by SLPA
97110	UB	Individual Physical Therapy by Physical Therapy Assistant
97150	U1, UB	Group Occupational Therapy by Occupational Therapy Assistant
97150	UB	Group Physical Therapy by Physical Therapy Assistant
97530	UB	Individual Occupational Therapy by Occupational Therapy Assistant

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