Billing and Coding: Billing and Coding: Outpatient Therapy Biofeedback Training - R2

This coverage article has been revised and published for notice under contract numbers: 01111 (CA), 01211 (AS, GU, HI, NMI), 01311 (NV), and 01911 (CA, HI & Territories).

Effective Date: January 1, 2020
Summary of Article Changes: Converted this article to a Billing and Coding article. Other updates included:

  • Added ‘physician and nonphysician practitioner (NPP)’ to the qualified provider as per CPT® described as “sometimes” therapy codes, which can be provided by physician/NPP outside a therapy plan of care and to ensure the article encompasses both Part A and Part B.
  • Added the Heading “Example of acceptable and unacceptable comparative measures” to make the section stand out by correct formatting of the examples and delete procedure codes with the descriptions from Article Text.
  • Deleted codes in the examples.
  • Added CMS IOM Medicare Claims Processing Manual, Publication 100-04, Chapter 5, Section 20(B) under Sources.
  • Added the following CPT codes effective 01/01/20.
    • 90912 - BIOFEEDBACK TRAINING, PERINEAL MUSCLES, ANORECTAL OR URETHRAL SPHINCTER, INCLUDING EMG AND/OR MANOMETRY, WHEN PERFORMED; INITIAL 15 MINUTES OF ONE-ON-ONE PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL CONTACT WITH THE PATIENT
    • 90913 - BIOFEEDBACK TRAINING, PERINEAL MUSCLES, ANORECTAL OR URETHRAL SPHINCTER, INCLUDING EMG AND/OR MANOMETRY, WHEN PERFORMED; EACH ADDITIONAL 15 MINUTES OF ONE-ON-ONE PHYSICIAN OR OTHER QUALIFIED HEALTH CARE PROFESSIONAL CONTACT WITH THE PATIENT (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE).

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            Last Updated Tue, 24 Nov 2020 19:50:15 +0000