GP Modifier Update

Are you aware modifier GP is being adopted by additional carriers as a requirement for reimbursement of physical medicine services?

This therapy modifier is required by United Health and its affiliates since 2020. The modifier GP is also required for VA claims and Medicare and Medicare Advantage plans.

More carriers are starting to require its use including Blue Cross Blue Shield of Michigan, Blue Cross of California (For California providers this does not include Blue Shield of California), and now also by BCBS plans of Indiana, Kentucky, Missouri, New Jersey, Ohio, Vermont, and Wisconsin.

All physical medicine codes 97010 through 97799 (PT codes) must be appended with a GP or denied as missing or incomplete.

If you get a denial indicating a missing modifier on a physical medicine code, the modifier GP may be the likely fix.

Billing with incorrect chiropractic CPT codes can lead to claim rejections and delays in payments, which can have a devastating impact on generating revenue and keeping you in business.