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Pennsylvania U Code and/or U Modifiers

nicholas Posted Thu 02nd of July, 2020 11:43:21 AM
In a previous question, I asked SUperCoder to define u modifiers and was told they are state defined levels of care. Specifically I would like the Pennsylvania Definitions for CPT Code 92507, In office (11), by a therapist (17) with U Modifier U3, U4, U9 and UB. If you are able to answer this questions please provide the source. We already know they are a PA Levels of Care but I want to know the PA definition. For example, in many states, adding the U3 modifier means that it was an individual treatment and a U4 is a co treatment. This link is the PA fee schedule for 92507, in office (11), by a therapist (17), specifically a speech therapist (173). https://www.humanservices.state.pa.us/OUTPATIENTFEESCHEDULE/Home/Details?provType=17&modCode;= &specCode=173&procCode=92507&pos=11&amt=21.70&begin=07/01/2004&end=12/31/2299
SuperCoder Answered Fri 03rd of July, 2020 09:23:25 AM

Hi Nicholas,

 

We have forwarded this query to our experts.

 

You would hear from us soon.

 

Thank you for all your patience.

 

Regards!

SuperCoder Answered Thu 09th of July, 2020 02:10:04 AM

Hi Nicholas,

 

Unfortunately, we are unable to answer this question.  We do not have access to state-specific Medicaid regulations.  We advise you to contact your Medicaid Representative to further inquire about the specific level of care definition.

 

Thanks for all the patience.

 

Regards!

 

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