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Code edit notification

Notification Number: 3614

Effective date: 4/5/2018

Notification date: 1/5/2018

Category: CPT

Topic: Florida Medicaid – Therapy treatments on the same day as evaluation

Providers affected:

  • Physician/Health Care Providers
What is changing?

We will not reimburse for physical therapy, occupational therapy and speech-language pathology treatments when provided the same day as an evaluation service for the same discipline.

Why is Humana implementing this change?

Agency for Health Care Administration (AHCA) coverage policies indicate that treatment visits are not covered when provided the same day as evaluation services.

Impacted products

  • Medicaid – Florida

Disclaimer

*All edits previously posted on Humana.com/providers for fully insured commercial Humana members may be applied to self-funded members, when requested by the self-funded group.