CLTS Interim TPA Service Authorization Guide for Statewide ...

CPT® code 96110 (developmental assessment) with modifier GP (physical therapist) is entered on claim line 1 in the HCPCS/Rate field (Box 44). An explanation of code 96110 is placed in the Description field (Box 43). The date of service for the assessment is placed in the Service Date field (Box 45) in the six-digit format (100115). ................
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