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Billing Notices for Horizon NJ Health Providers
Posted By Admin on December 18, 2017
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Bilateral Billing:

Horizon NJ Health is asking providers to no longer bill modifiers LT/RT on bilateral procedures. Effective January 1, 2018, when a bilateral (LT/RT) procedure is performed, providers are asked to bill modifier 50 to align with the Centers for Medicare and Medicaid Services’ (CMS) Medically Unlikely Edits (MUE) rules and to avoid any MUE denials. Please refer to the CMS guidelines.

Therapy Billing:

Horizon NJ Health is requesting providers that bill Occupational Therapy (OT)/Physical Therapy (PT)/Speech Therapy (SP) and that have contracts that pay one modality per date of service to bill the highest amount on the last line per date of service billed.