News: CMS releases 2024 Therapy Code List and Dispositions

CMS posted its 2024 Therapy Code List and Dispositions on December 28, JustCoding reported. This list indicates whether therapy services, as distinguished by HCPCS Level II and CPT codes, are recognized under CMS as “sometimes therapy” or “always therapy.” CMS draws information from the Medicare Physician Fee Schedule (MPFS) and assigns a disposition “code” (number 1-10) to the HCPCS or CPT code to do this.

The disposition codes and their summarized definitions are as follows:

1. The MPFS does not contain prices for these codes; they are priced by the Medicare Administrative Contractor.
2. CPT code 97760 should not be reported with CPT code 97116 for the same extremity.
3. These codes are bundled under the MPFS; regardless of whether they are billed alone or in conjunction with other therapy codes, never make payment separately for these codes, but some reason codes can be used.
4. These codes are always paid as non-therapy services for hospital or critical access hospital (CAH) outpatients.
5. These codes are “always therapy” services, regardless of who performs them; they require therapy modifier(s).
6. These OPPS-designated “sometimes therapy” codes may be paid as non-therapy services for hospital or CAH outpatients.
7. These codes are “sometimes therapy,” but are “always therapy” when furnished by a qualified therapist under a plan of care (and require a therapy modifier). There are conditions in which codes marked with this disposition code are not therapy services. The 2024 update added three codes and gave them this disposition code.
8. These nonpayable HCPCS G-codes are used only for functional reporting, which was discontinued January 1, 2019. 
9. These evaluation and re-evaluation codes require a therapy modifier to indicate when the evaluative service is furnished under a plan of care.
10. These certain codes are for communication technology-based services or remote therapeutic monitoring services.

Editor’s note: To read JustCoding’s coverage of this article, click here. To read the 2024 Therapy Code List and Dispositions, click here.