Skip to main content
  • Medicaid Provider Alert: Provider revalidation has begun and those not completing the process risk disenrollment.  Check your account now to learn when your revalidation is due. More information here.
Elizabeth M. Whitehorn, Director

Provider Notice issued 08/20/14

Error Code G61 – therapy claims missing appropriate modifier

To:​ Local Health Departments; Hospitals; and Therapists​
​Date: ​August 20, 2014
​Re: Error Code G61 – therapy claims missing appropriate modifier​

The purpose of this notice is to inform providers that effective May 21, 2014, the department implemented claims processing editing that result in claim rejections for physical, occupational, and speech therapy services billed without a modifier.

Claims must identify the type of therapy by using the appropriate modifier:

  • GP - Required when billing Physical Therapy services

  • GO - Required when billing Occupational Therapy services

  • GN - Required when billing Speech Therapy services

Claims for therapy services billed without the applicable modifier will receive error code G61 - Service Not Covered without Procedure Modifier GP, GO, or GN.

Providers were also reminded of this billing requirement in the October 31, 2013 provider release Therapy Prior Approval Request Change and Therapy Modifier Billing Reminder (pdf).

Please note this billing guideline does not apply to Early Intervention claims submitted to the Early Intervention Central Billing Office (CBO). Early Intervention claims submitted to the CBO should continue to be billed according to the instructions in the Early Intervention Provider Handbook (pdf).

Questions regarding this notice may be directed to the Bureau of Professional and Ancillary Services at (877)782-5565, option 3, option 5.

Theresa A. Eagleson, Administrator

Division of Medical Programs