Name of Manual - Blue Cross and Blue Shield of Minnesota

Massage and Manual
Therapy Exclusion
(continued)
Speech Therapy and
Evaluation
Patient Billing Impact
Coding Policies and Guidelines (Rehabilitative Services)
The patient is not responsible and must not be balance billed for
any procedures for which payment has been denied or reduced by
Blue Cross as the result of a coding edit. Edit denials are designed
to ensure appropriate coding and to assist in processing claims
accurately and consistently.
Subscriber liable:
Coverage for massage and manual therapy (97124 and 97140)
services provided without a physical medicine therapy is subject to
the subscriber’s contract benefits. Some benefit plans may not
cover this service.
Speech therapists, physicians, or M.D. clinics should use CPT
code 92507 for their speech therapy services and 92506 for speech
evaluation. Submit one unit of service per encounter.
If a speech evaluation is done over a period of two days, but only
one report is generated, submit 92506 only once on the day the
evaluation is completed.
“Timed” Unit Reporting When a procedure/service indicates time, more than half of the
designated time must be spent performing the service in order for a
unit to be billed. In the case of a 15 minute service - at least 8
minutes must be performed, for a 30 minute service - at least 16
minutes, for a 60 minute service - at least 31 minutes, and so on.
If more than one modality or therapy is performed, time cannot be
combined to report units. Do not follow Medicare’s rounding rules
for speech, occupational, and physical therapy services. Each
modality and unit(s) is reported separately by code definition. Do
not combine codes to determine total time units.
For example, if two 15 minute defined modalities are performed
but only 7 minutes or less is spent per modality, neither service
should be reported.
Blue Cross and Blue Shield of Minnesota Provider Policy and Procedure Manual (03/19/12)
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