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Modifier CQ and CO: PTA & OTA Payment Reductions

Last Updated: October 16, 2025

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In an effort to cut costs, Medicare passed a law reducing payments for therapy services provided in whole, or in part, by Physical Therapist Assistants (PTAs) and Occupational Therapy Assistants (OTAs).

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When to Use CQ and CO

You must append the modifier if a PTA or OTA provides more than 10% of the service for any given CPT code.

  • CQ: Services provided by a PTA.
  • CO: Services provided by an OTA.

Compare CPT Codes

Confused between with vs. without contrast? Look up the official code descriptions.

The 85% Payment Rule

When Medicare sees the CQ or CO modifier on a claim line, they automatically reduce the reimbursement for that specific CPT code to 85% of the standard physician fee schedule.

Verify Medical Necessity

Don't risk a denial. See if your ICD-10 code is on the approved Medicare LCD list.

NCCI Edits and Modifier Stacking

These modifiers are informational but affect payment. You must stack them with the discipline modifiers. Example: A PTA performing manual therapy would bill 97140-59-GP-CQ.

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Modifier CQ and CO: PTA & OTA Payment Reductions