Anthem has updated its professional reimbursement policy. This policy change requires that claims with physical medicine services 97010-97799 will require modifier GP. The modifier is required for dates of service after April 1, 2021.

Any PT now billed to Anthem will require the GP modifier. Note this modifier may be in addition to other modifiers that may be necessary such as 59 or XS on 97112, 97124, or 97140, Note the order of the modifiers is not critical but that both must appear.

This policy also indicates that any constant attendance or timed services will be limited to 4 units or one hour per date of service.

The use of the GP modifier is required now on all claims to United Health Care and their affiliates, VA claims, Medicare claims, Blue Cross Blue Shield of Michigan and now Anthem Blue Cross of California.


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