MedicaidBilling CodesHigh impact
Microsoft Word - MAB PT Codes_EI Crosswalk_Rev 1_B. wilhelm 6 14 06_1.doc
Pennsylvania Medicaid (DHS)·PA · Physical Therapy, Occupational Therapy, Speech Therapy +1 more·Provider Bulletin
Effective date
Jul 1, 2006
We identified it
Jun 20, 2026
Summary
Starting July 1, 2006, Pennsylvania Medical Assistance (Medicaid) requires specific pricing modifiers for therapy evaluation codes to ensure proper payment when services are not provided as Early Intervention services. Physical therapy evaluations (97001) and occupational therapy evaluations (97003) must use modifier U8, while speech/language evaluations (92506) must use modifier U9.
Action Required
By July 1, 2006: Billing team must update billing system to automatically append modifier U8 to CPT codes 97001 and 97003, and modifier U9 to CPT code 92506 for all Pennsylvania Medicaid claims when services are not Early Intervention services. Update encounter forms and train therapists on modifier requirements. Claims without appropriate modifiers will result in inappropriate payments or denials.