Services delivered under an outpatient speech language pathology plan of care

Correct Use

• Submit modifier GN to indicate that services were delivered under an outpatient speech language pathology plan of care
• If additional modifiers are required with service, modifier GN must be submitted in first or second modifier position
• Exception: Claims from physicians (all specialty codes) and non-physician practitioners, including specialty codes 50, 89, and 97, may be processed without therapy modifiers for sometimes only therapy codes
• If specialty codes 65 and 67 are on claim and an applicable HCPCS code is without one of the therapy modifiers (GN, GO, GP), claim will be returned as unprocessable

Resource

• CMS Internet Only Manual (IOM), Publication 100-02, Medicare Benefit Policy Manual, Chapter 15, Section 220