When does this change take effect?

This change is effective May 21, 2014.

MedicaidBilling CodesHigh impact

Error Code G61 – therapy claims missing appropriate modifier

Q: Who is affected by this change?

This affects Illinois Medicaid - HFS Physical Therapy, Occupational Therapy, Speech Therapy providers in IL on Medicaid plans.

Illinois Medicaid - HFS·IL · Physical Therapy, Occupational Therapy, Speech Therapy·Provider Notice

Effective date

May 21, 2014

We identified it

Jun 20, 2026

Days to comply

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Summary

Effective May 21, 2014, all physical, occupational, and speech therapy claims must include specific modifiers (GP for physical therapy, GO for occupational therapy, GN for speech therapy) or they will be rejected with error code G61. Claims submitted without these required modifiers will be denied as 'Service Not Covered without Procedure Modifier.'

Action Required

Action needed

Immediately: Billing team must update all therapy billing workflows to require modifiers GP (Physical Therapy), GO (Occupational Therapy), and GN (Speech Therapy) on all respective therapy claims. Update billing software validation rules and encounter forms to prevent submission without appropriate modifiers. Train staff that claims without these modifiers will receive error code G61 and be denied.

Related policy hubs

Illinois Medicaid - HFS policies IL policy changes Physical Therapy Occupational Therapy Speech Therapy