How to Add the KX Modifier

In this article we will discuss how to enable to KX modifier to auto populate in HENO once a patient has reached their cap. 

Initial settings that you would want to have enabled include: 

• The "Track Allowable Amount Billed for KX" checkbox selected from within the Insurance's Plan.
• Enter in your Company Rates with the Allowed Section being your Medicare State's Fee Schedule
  • We have this article that describes how to set up insurance company rates: Setting up Company Rates

Track Allowable Amount Billed for KX:

Company Rates with the allowed fee schedule: 

With that initial set up there are two ways to enable the KX modifier

1) From the CPT Checkout screen:

When adding in CPT Codes and HENO and the patient is approaching their cap a notification will appear where you can click on  "Enable KX Rules" to turn on the KX Modifier.

2) Within a Patient's Profile

Click "Patients Tab" > Search your patient > Click on the Edit Pencil

Now inside of the Patient's Profile within their Details Tab you can select "Cap".

To move over the KX for OT or PT/Speech you will double click on the one you would like to enable and move it form the left side of the shuttle to the right side to enable.

Once the KX rule is in the right side of the shuttle please click "Apply Changes to Enable for that Patient" 

Tracking KX:

If you would like to see patients that have their KX modifier turned on or those that are approaching the cap, this can be found in the Reports > KX Tracking

Reset/ Turn Off KX Modifiers

At the end of the calendar year and your Medicare Patients have reset their caps, once you have completed checking out all of your prior year's patients you can reset the KX tracking:

Admin > Practice > Medicare > Remove all KX Rules > Apply Changes

Please let us know if you have any questions with this article at support@heno.io