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Physical Therapy Billed on a UB-04

Provider Administrative Policy

Ancillary Provider
Policy Date
February 2008
Revised/May 2008
Provider Type(s)
Physical Therapist  


Our provider administrative policies contain information regarding claims submission, reimbursement, and other information in order to achieve an efficient relationship with our providers. These policies are not an authorization or explanation of benefits. Blue Cross of Idaho retains the right to add to, delete from and otherwise modify this policy in accordance with our provider contracts.


Physical Therapy Billed on a UB-04

Please submit all Medicare physical therapy claims according to the following guidelines.

  • Submit Medicare physical therapy claims to Medicare for reimbursement. When you receive the Medicare reimbursement, send the Medicare remittance advice and claim to Blue Cross of Idaho for claims processing.

You must follow this procedure because Medicare does not automatically crossover physical therapy claims billed on UB-04 forms to Blue Cross of Idaho.

Policy History

Date Action Reason
July 2011 Revised Removed "a CMS 1500" preceding claim.
May 2008 Revised Title change

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