Medicare Claims Processing Manual (Pub. 100-04), Ch. 6 § 110.2.6
Edit for Therapy Services Separately Payable When Furnished
110.2.6 - Edit for Therapy Services Separately Payable When Furnished
by a Physician
(Rev. 1757, Issued: 06-19-09, Effective: 07-20-09, Implementation: 07-20-09)
A number of therapy services are considered separately payable when provided by a
physician and shall be paid separately by the A/B MAC (B). However, these services are
considered therapy when provided by a physical or occupational therapist and are subject
to consolidated billing.
Effective for claims with dates of service on or after July 1, 2004, edits will be
implemented in the claims processing system to correctly process claims for these
services. A complete list of these services can be found on the CMS website at
https://www.cms.gov/Medicare/Billing/SNFConsolidatedBilling/.