016-06-05 Ark. Code R. § 87
Procedure Code | Modifier | Description |
97110 | UB | Home Health Physical Therapy by a Qualified Physical Therapy Assistant |
97110 | Home Health Physical Therapy by a Qualified Licensed Physical Therapist |
Hospital/Critical Access Hospital (CAH)/End Stage Renal Disease (ESRD)
Procedure Code | Modifier | Description |
T1015 | U1 | Outpatient Hospital Clinic Room Charge. This room charge includes supplies and non-physician staffing. |
77417 | U1 | Therapeutic Radiology Port Film(s) |
77417 | U2 | Therapeutic Radiology Port Film(s) |
77417 | U3 | Therapeutic Radiology Port Film(s) |
92507 | UB | Individual Speech Therapy by SLPA |
92508 | UB | Group Speech Therapy by SLPA |
97110 | UB | Individual Physical Therapy by Physical Therapy Assistant |
97150 | U1, UB | Group Occupational Therapy by Occupational Therapy Assistant |
97150 | UB | Group Physical Therapy by Physical Therapy Assistant |
97530 | UB | Individual Occupational Therapy by Occupational Therapy Assistant |
99401 | UA | Outpatient Hospital Clinic Room Charge?Periodic Family Planning Visit |
99402 | UA | Outpatient Hospital Clinic Room Charge?Basic Family Planning Visit |
Rehabilitative Hospital
Treatment and therapy procedure codes may not be billed in conjunction with revenue code T1015. Medicaid reimbursement for a treatment/therapy room is included in the therapy reimbursement.
Procedure Code | Modifier | Description |
T1015 | U1 | Outpatient Hospital Clinic Room Charge. This room charge includes supplies and non-physician staffing. |
92507 | UB | Individual Speech Therapy by SLPA |
92508 | UB | Group Speech Therapy by SLPA |
97110 | UB | Individual Physical Therapy by Physical Therapy Assistant |
97150 | U1, UB | Group Occupational Therapy by Occupational Therapy Assistant |
97150 | UB | Group Physical Therapy by Physical Therapy Assistant |
97530 | UB | Individual Occupational Therapy by Occupational Therapy Assistant |
016.06.05 Ark. Code R. § 087