AOTA has resources for occupational therapists on the new reporting requirements that became effective July 1, 2013. Practitioners billing for outpatient therapy services under Medicare Part B must now report functional data on their claims in order to be reimbursed. Functional data reporting takes the form of new G-codes, which identify the primary issue being addressed by therapy, and modifiers that reflect the patient’s impairment/limitation/restriction. All Medicare outpatient billing must include this new functional data, which will be used to track patient achievement of goals over time.
It is critical to understand that all G-codes are available to be used by all therapy disciplines. For example, memory, swallowing, and cognition are able to be used by occupational therapists.
AOTA suggests that the “Other PT/OT” code categories will not clarify the specific occupational therapy intervention goal. Be sure to use any code that fits your work with a patient, and be as specific as possible.