In our March Blue Review, we included an article on page 4 titled, “New Modifiers Added for Outpatient Therapy Services.” This article referenced BCBSIL’s request for provider use of modifiers “GP” and "GO," appended to the appropriate CPT code, to clearly identify situations where Physical (GP) and Occupational (GO) therapy services were rendered.

In response to provider questions regarding this article, we would like to clarify the following points:

• Use of the GP and GO modifiers is not required. However, using these modifiers will help ensure that any patient accumulations (charges, visits) are applied to the appropriate benefit where limitations/maximums may exist.
• The GP and GO modifiers do not indicate what type of provider performed the service. Rather, these modifiers are used to identify the service that was delivered.
• These modifiers may be used by physicians, nurse practitioners, physician assistants, and other qualified health care providers when billing for physical/occupational therapy services delivered under an outpatient plan of care.

Please continue to watch the "What’s New" section for additional updates and information. If you have questions on a specific claim, contact our Provider Telecommunications Center (PTC), at (800) 972-8088.

Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility, any claims received during the interim period and the terms of the member’s certificate of coverage applicable on the date services were rendered.