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New E&M codes for the year 2019

For 2019, the E&M section of CPT code book will have two new codes for Interprofessional Telephone/Internet/Electronic Health Record...

Modifier FY


Beginning January 1, 2018, and including Calendar Years (CY) 2018-CY 2022, a payment reduction of 7 percent applies to the technical component (and the technical component of the global fee) for computed radiography services

Similarly, if such X-ray services are furnished during CY 2023 or a subsequent year, a payment reduction of 10 percent applies to the technical component (and the technical component of the global fee) for computed radiography services.

To be noted:

Providers must submit this modifier with the X-ray CPT code for each X-ray taken using computed radiography

The beneficiary is not liable for the FY modifier payment reduction

When the payment reduction is made, the following remittance messages will be used:

  • Claim Adjustment Reason Code (CARC) 237 – Legislated/Regulatory Penalty.
  • Remittance Advice Remark Code (RARC) N794 – Payment adjusted based on type of technology used.
  • Group Code: CO (contractual obligation).
For more information: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/MM10188.pdf

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