If you are enrolled in Medicaid, you must renew once a year or you will lose your coverage.

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Therapy Modifier Notice

Dear Providers,

Many payors, including Medicaid, are requiring the use of a therapy modifier to identify when a therapy service is furnished under an SLP, OT, or PT plan of care, respectively.

To be consistent, MPC will now require the use of one of these three therapy modifiers (GN, GO, or GP) for the following (HCPCS):

SLP Codes
Code Description Modifier
92521 Evaluation of speech fluency GN
92522 Evaluate speech production GN
92523 Speech sound lang. comprehend GN
92524 Behavioral quality analysis voice GN
92597 Oral speech device eval. GN
92607 Ex for speech device Rx 1hr GN

 

OT Codes
Code Description Modifier
97165 OT eval low complex 30 min GO
97166 OT eval mod complex 45 min GO
97167 OT eval high complex 60 min GO
97168 OT re-eval est. plan care GO

 

PT Codes
Code Description Modifier
97161 PT eval low complex 20 min GP
97162 PT eval mod complex 30 min GP
97163 PT eval high complex 45 min GP
97164 PT re-eval est plan care GP

The following HCPCS codes will also require the modifiers as appropriate:

92507 92508 92526 92608 92609 96125 97012 97016
97018 97022 97024 97026 97028 97032 97033 97034
97035 97036 97039 97110 97112 97113 97116 97124
97139 97140 97150 97530 97533 97535 97537 97542
97750 97755 97760 97761 97762 97799 G0281 G0283
G0329

 

If you have any questions, please call your Provider Services department toll-free at 1-800-953-8854.

 

Know The Facts About Coronavirus (COVID-19)

Symptoms are flu-like, including: fever, coughing, and shortness of breath.

If you think you might have been exposed, contact your doctor immediately. You can also have a video visit with a doctor using the MyVirtualMPC app.

It is important to do everything you can to protect yourself from COVID-19.

Important Claims Processing Update

Effective 6/14/2021, all paper claims regardless of DOS should be sent to:
Maryland Physicians Care
P.O. Box 21099
Eagan, MN 55121