Payment
Modifier 22
What is Increased Procedural Services (surgical/procedures codes only)
Therapy Threshold - Documentation meets medical policy requirements.
What is Modifier KX
Modifier 95
What is synchronous telemedicine service rendered via real-time interactive audio and video telecommunications provided during the COVID19 pandemic only.
Modifier XE
What is a Separate encounter, A service that is distinct because it occurred during a separate encounter
Acute or Active Treatment under Chiropractic care
What is Modifier AT
Modifier 50
What is Bilateral Procedure
Under a PT plan of care, services are personally delivered by a Physical Therapist Assistant
What is modifier CQ
Attending physician is not a hospice employee
Modifier XP
What is a Separate Practitioner, A service that is distinct because it was performed by a different practitioner
To report a required ABN was issued for a service and is on file. A copy of ABN does not have to be submitted, but must be made available upon request
What is Modifier GA
Modifier 51
What is Multiple procedures
Under a PT plan of care, services are personally delivered by a Physical Therapist
What is Modifier GP
Counseling or Therapy provided, Audio-Only, during Post Pandemic, after Health Emergency Ended.
What is Modifier FQ
Modifier XS
What is a Separate Structure, A service that is distinct because it was performed on a separate organ/structure
To report item or service that is statutorily excluded or does not meet definition of any Medicare benefit
What is Modifier GY
Modifier 79
What is Unrelated procedure or service by the same physician during the postoperative period.
SLP Plan of care or Service is personally delivered by a Speech-Language Pathologist
What is Modifier GN
Service not related to the hospice patient’s terminal condition
What is Modifier GW
Modifier XU
What is an Unusual Non-Overlapping Service, the use of a service that is distinct because it does not overlap usual components of the main service
To report an ABN was not issued for a service
What is Modifier GZ
Modifier 53
What is Discontinued / Terminated Procedure
Under a PT plan of care, services are personally delivered by a Occupational Therapist Assistant
What is Modifier CO?
Professional Component, Supervision and Interpretation
What is Modifier 26
Distinct or Separate Procedural Service
What is Modifier 59
To report a voluntary ABN was issued for a service
What is Modifier GX