MS Mediciad LBN 5/7/2026 - When submitting prior authorization (PA) requests to Telligen for Therapy services, please include the appropriate modifier on the PA that will be used when billing the associated Therapy claim. This will prevent claim denials for duplicate services. Modifiers listed on the PA must match exactly with the modifier on the corresponding claim.

The following modifiers are acceptable for therapy services:

GN – Outpatient Speech Language Service
GO – Outpatient Occupation Therapy Service
GP – Outpatient Physical Therapy Service

Please note that this requirement applies to Prior Authorization (PA) requests submitted moving forward beginning May 7th.

• No action is needed from providers for any cases submitted prior to May 7th.
• For any new PA requests submitted on or after May 7th, the required modifier(s) must be appended at the time of submission.
• Any PA request submitted on or after May 7th with a missing modifier will result in a Request for Information (RFI). To respond to the RFI, providers will be required to submit a Change Request Form or Word document identifying the appropriate modifier(s) to be added to the authorization request.

Reminder: When entering an authorization request in the Telligen Qualitrac portal, the treating provider is considered the therapy provider (group or individual) who will render the therapy services. The ordering provider must be a physician, physician assistant or nurse practitioner.