United Healthcare requiring GP Modifiers on PT Codes

Effective September 1st, 2019, United Healthcare (UHC) will require GP modifiers on all physical therapy (PT) procedures in alignment with Medicare’s rules. The GP modifier indicates that the PT services are performed “under an outpatient physical therapy plan of care.” To comply with this requirement, please make sure your notes include the treatment plan, which should contain the patient’s diagnosis, goals, progress, and anticipated treatment duration. 

After September 1st, UHC will reject any PT charges billed without the modifier. Appropriate documentation is necessary to ensure your services are in line with their requirements, preventing unnecessary denials or recoupments.

Brandon McCurdy