Effective February 15, 2026, professional claims for Physical Therapy (PT), Speech Therapy (ST) and Occupational Therapy (OT) services that include an ICD-10 diagnosis code requiring the seventh character “A” in any position will be denied.
If a modality procedure code is submitted on the same date of service, by the same provider, and with the same diagnosis code as the therapy procedure code, the modality claim line will also deny. We have updated our policies with this information.