HomeCommunity ResourcesFinding a Professional ASHAOther ResourcesProfessional ResourcesPrivate PracticeHealthcareSchoolsNews ItemsAlaska Licensure & CertificationOtherStudent ResourcesConventions & Community EducationJob Listings Advertising
Opportunities
AwardsLegislative Updates About Us Contact Us
Private Practice
Hot Topics :: Speech-Language Pathology :: Audiology
Hot Topics
Exceptions Process Alert—CMS Provides Additional Instruction on KX Modifier
The Centers for Medicare and Medicaid Services (CMS) has identified a glitch in the use of the KX modifier for exceptions to the therapy cap on claims processed by Medicare fiscal intermediaries (FIs) and has issued revised instructions on the use of the modifier.
Effective immediately, providers should insert the KX modifier on all speech-language pathology and physical therapy line items on the same claim form, if the KX modifier is appropriate for at least one of the SLP or PT services on the intermediary claim form. Claims with a KX modifier that have been denied by the FI due to this processing error should be resubmitted for payment.
In a recently released article published by CMS in its MedLearn Matters, the agency states that providers will not be penalized for using the KX modifier on medically necessary services that would be eligible for an exception when those services are below the cap and filed on the same claim form as services that meet the exceptions process criteria and appropriately use the KX modifier. The MedLearn Matters article can be found here.
Additional information on the therapy caps exceptions process can be found here. Questions about the exceptions process or the new claims processing requirements can be directed to Ingrida Lusis, ASHA’s Director of Health Care Regulatory Advocacy.
Speech-Language Pathology
Private Practice Resources
American Academy of Private Practice in Speech Pathology and Audiology
Council of Academic Programs In Communication Sciences and Disorders (CAPCSD)
ADVANCE for Speech-Language Pathologists & Audiologists: Ongoing Educational Programs
Audiology
Private Practice Resources
American Academy of Private Practice in Speech Pathology and Audiology
Council of Academic Programs In Communication Sciences and Disorders (CAPCSD)
ADVANCE for Speech-Language Pathologists & Audiologists: Ongoing Educational Programs
Member Resources Member LoginMembership Directory Membership Renewal Listserv (Blog) Newsletter Volunteer Opportunities Request for ActionBoard & Committees