Habilitative Services and Devices Coding Requirements
Issue: #399 JAN2018
Effective January 1, 2018, a new modifier, modifier 96, is available to identify habilitative services and devices. Modifier SZ was discontinued on December 31, 2017. Providers must submit modifier 96 for habilitative services and devices in conjunction with Patient Protection and Affordable Care Act (PPACA).
Habilitative therapy is defined as care provided for conditions that have limited normal age-appropriate motor, sensory or communication development. This is necessary to support the requirements of the Affordable Care Act (ACA) Essential Health Benefits.