What Does Modifier Kx Mean

Requirements specified in the applicable Local Coverage Determination

When should the KX modifier be used?

The KX modifier should only be used when the therapist (not the biller or the billing company) has made a determination that skilled therapy is medically necessary over the $1920 therapy caps.

Is KX a payment modifier?

Using the KX Modifier This includes documentation that patients, based on their condition, require continued skilled therapy—ie, therapy beyond the amount payable under the threshold to achieve their prior functional status or maximum expected functional status within a reasonable amount of time.