The New 2020 Therapy HCPCS codes have been added to eQSuite®:
If the PAR had a start date on or after January 1, 2020. please submit a HelpLine ticket requesting a correction. Please include the code(s) and/or modifier that was affected along with the PAR number or review ID. Those corrections will be added to the review for eQHealth staff to process.
If the PAR had a start date prior to January 1, 2020, please submit a modification request for that PAR with the new code(s) and/or modifier affected. The modification request start date should reflect January 1, 2020, and should only include the units needed for January 1, 2020, through the end date of that PAR, and the total number of combined units should not exceed the total number of units approved on the original PAR.
G0515 (2019 code) = 97129, 97130 (2020 codes)
97799 (2019 code) = 20560, 20561 (2020 codes)
Due to our system some type of documentation is required to be uploaded with a modification. Providers can upload a document saying “This modification is due to the 2020 HCPCS Therapy code change”.
These correction requests will be permitted through June 30, 2020. Beginning July 1, 2020 these correction requests will no longer be permitted.
We are now taking Access Requests forms for Speech Therapy. Please fill out an access form and e-mail to it to Provider Relations at email@example.com
eQSuite Access Form
We have also started to schedule the provider Training webinars. Please go here to view webinar training schedule.
Please refer to the Colorado Medical Assistance Program Outpatient Speech Therapy Fee Services Provider Reference Manual and the 8.200.2.D.1 The Speech-Language and Hearing Services Benefit Coverage can be located at the Colorado Secretary of State’s website here.
Occupational and Physical Therapy
To view the Occupational and Physical PAR training presentation please click on the following link. You will need to sign into gotowebinar to view and listen to the presentation.
Physical and Occupational Therapy Billing Guide
Please click the link below which will take you the the Colorado HCPF Billing Guides. You will then click on CMS 1500 and Physical and Occupational Therapy.
Adult Habilitative Speech Therapy Presentation
This document contains a copy of the presentation for prior authorization of adult habilitative speech therapy. The training highlights the definition of medical necessity and habilitative services, benefit coverage and limitations, the PAR process and required supporting documentation necessary for review.
Habilitative Speech Therapy PAR information
Please visit Presentations & Video Tutorials for the pre-recorded training sessions and PDF of the power points.