New Policy Lets PTs Bill Medicare for Canalith Repositioning Using 97112 Code

PTs can now can bill Medicare for canalith repositioning procedures using CPT code 97112 (neuromuscular reeducation).

In the final 2009 physician fee schedule rule, the Centers for Medicare and Medicaid Services (CMS), Washington, had made a decision to bundle the code, which would not allow for separate payment under the newly created CPT code (95992) that was developed to describe canalith repositioning procedures.

The American Physical Therapy Association (APTA) has urged CMS to change this policy to allow PTs to continue to provide and bill for this service using the 97112 code. Following APTA’s request, PTs now can continue to bill for canalith repositioning using CPT code 97112 retroactive to January 1, 2009.

The organization recommends that PTs contact their Medicare contractor to ensure that the contractor is aware of the new policy and request their guidance on resubmission of claims for these procedures.

Additional background information is available in a CMS Transmittal. A Medlearn Matters article announcing this policy change is available at this link.

[Source: APTA]