I would bill with the modifiers if your MAC says to. I think it is important to check with them as you are in one of the states that you have to take the risk. Really tough situation to be in. I would not assume that Novitas in another area has the same "rules". If any of your therapists belong to the APTA I would call them. They have are an excellent resource but you will need to identify the member to get information.
Merry