HCPCS Level II Modifiers List, HCPCS Level II Modifiers, hcpcs level ii code modifiers

2022 – HCPCS Level II Modifiers List (2022 Updated)

HCPCS level II modifiers are used to identify procedure codes that are not included in CPT codes and not covered by list of CPT modifiers. They are used to identify services, supplies or products such durable medical equipment, ambulance services, orthotics, etc.

What Are HCPCS Level II Modifiers?

As mentioned in the introduction, HCPCS Level II Modifiers can be used to identify supplies, products, and/or services which not included in CPT codes.

Examples are:

  • prosthetics;
  • orthotics;
  • durable medical equipment;
  • ambulance services; and/or
  • supplies (DMEPOS) when they are used outside a Physician’s office.

Level II HCPCS modifiers were established October 2003 to cover a variety of supplies, services or products that are not described by CPT codes so claims to medicare and other insurers can be submitted with these items included.

TIP: You can find the list of CPT modifiers here.

Below you can find the HCPCS Level II Modifiers with descriptions and guidelines.

Modifier A1

What is modifier A1? Dressing for one wound.

When to use a A1 modifier? Modifier A1 can be used to identify a surgical dressing a surgical supplier (or health provider) has used for the dressing of a single wound.

Modifier A2

What is modifier A2? Dressing for two wounds.

When to use a A2 modifier? Modifier A2 can be used to identify a surgical dressing a surgical supplier (or health provider) has used for the dressing of two wounds.

Modifier A3

What is modifier A3? Dressing for three wounds.

When to use a A3 modifier? Modifier A3 can be used to identify a surgical dressing a surgical supplier (or health provider) has used for the dressing of three wounds.

Modifier A4

What is modifier A4? Dressing for four wounds.

When to use a A4 modifier? Modifier A2 can be used to identify a surgical dressing a surgical supplier (or health provider) has used for dressing four wounds.

Modifier A5

What is modifier A4? Dressing for five wounds.

When to use a A5 modifier? Modifier A2 can be used to identify a surgical dressing a surgical supplier (or health provider) has used for dressing five wounds.

Modifier A6

What is modifier A6? Dressing for six wounds.

When to use a A6 modifier? Modifier A2 can be used to identify a surgical dressing a surgical supplier (or health provider) has used for dressing six wounds.

Modifier A7

What is modifier A7? Dressing for seven wounds.

When to use a A7 modifier? Modifier A2 can be used to identify a surgical dressing a surgical supplier (or health provider) has used for dressing seven wounds.

Modifier A8

What is modifier A8? Dressing for eight wounds.

When to use a A8 modifier? Modifier A2 can be used to identify a surgical dressing a surgical supplier (or health provider) has used for dressing eight wounds.

Modifier A9

What is modifier A9? Dressing for nine or more wounds.

When to use a A9 modifier? Modifier A2 can be used to identify a surgical dressing a surgical supplier (or health provider) has used for dressing nine wounds or more.

Modifier AA

What is modifier AA? Anesthesia services performed personally by anesthesiologist.

When to use an AA modifier? Modifier AA can be used for anesthesia procedures when the health provider personally performs the anesthesia service without help of others.

Modifier AD

What is modifier AD? Medical supervision by a physician: more than four concurrent anesthesia procedures.

When to use an AD modifier? Modifier AD can be used when an anesthesiologist provides medical supervision for four or more overlapping procedures.

Modifier AE

What is modifier AE? Registered dietician.

When to use an AE modifier? Modifier AE can be used to for services provided by a nutrition professional. 

Modifier AF

What is modifier AF? Specialty physician.

When to use an AF modifier? Modifier AF can be used to report services provided by a specialty physician. This modifier is only applicable in a physician scarcity area.

Modifier AG

What is modifier AG? Primary physician.

When to use an AG modifier? Modifier AG can be used to report services provided by a primary care physician. This modifier is only applicable in a physician scarcity area.

Modifier AH

What is modifier AH? Clinical psychologist.

When to use an AH modifier? Modifier AH can be used to report services provided by a clinical psychologist.

Modifier AI

What is modifier AI? Principal physician of record.

When to use an AI modifier? Modifier AI can be used to report services provided by a provider responsible for a patient’s overall care. Report this modifier only for nursing home visits and initial hospital codes.

Modifier AJ

What is modifier AJ? Clinical social worker.

When to use an AJ modifier? Modifier AJ can be used to report services a clinical social worker provides.

Modifier AK

What is modifier AK? Non-participating Physician.

When to use an AK modifier? Modifier AK can be used to report services provided by a non-participating Physician.

Modifier AM

What is modifier AM? Physician. Team member service.

When to use an AM modifier? Modifier AM is mainly used to report services provided by a Physician assistant (who is part of the provider’s team) but can also be reported for other members of a provider’s team.

Modifier AO

What is modifier AO? Alternate payment method declined by the provider of service.

When to use an AO modifier? Modifier AO can be used on claims and must be appended on each line if a health provider declines participation in an alternate payment method by the payer.

Modifier AP

What is modifier AP? Determination of refractive state was not performed in the course of diagnostic ophthalmological examination.

When to use an AP modifier? Modifier AP can be used for eye examination services. Only report his modifier to codes that indicate the reimbursement does not include a fee for the determination of a refractive state.

It is also possible to report this modifier for a process determining the patient’s refractive error and need for lenses or glasses.

Modifier AQ

What is modifier AQ? A physician providing a service in an unlisted health professional shortage area (HPSA).

When to use an AQ modifier? Modifier AQ can be used to report services that are rendered by the health provider in zip code areas that are not part of the “Health Professional Shortage Area (HPSA).

Modifier AR

What is modifier AR? Physician provider services in a Physician scarcity area.

When to use an AR modifier? Modifier AR can be used to report services of a Physician provider in a Physician scarcity area.

Modifier AS

What is modifier AS? Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery.

When to use an AS modifier? Modifier AS can be used to report services provided by a health care professional who acts as an assistant during a surgical procedure.

Modifier AT

What is modifier AT? Acute treatment (chiropractic claims).

When to use an AT modifier? Modifier AT can be used to report treatment of the acute or chronic spinal subluxation with;

  • CMT
  • specific chiropractic manipulative treatment; or
  • spinal codes.

Modifier AT should be used when reporting CPT 98940, CPT 98941, or CPT 98942.

Modifier AU

What is modifier AU? Item furnished in conjunction with a urological, ostomy, or tracheostomy supply.

When to use an AU modifier? Modifier AU can be used for HCPCS codes or with the Healthcare Common Procedure Coding System, which identify the supply associated with;

  • ostomy procedures;
  • tracheostomy procedures; or
  • urological procedures.

Modifier AV is only applicable for the HCPCS codes; A4450 (Tape, nonwaterproof, per 18 sq in), A4452 (Tape, waterproof, per 18.. Read more..

Modifier AV

What is modifier AV? Item furnished in conjunction with a prosthetic device, prosthetic or orthotic.

When to use an AV modifier? Modifier AV can be used for HCPCS codes or with Healthcare Common Procedure Coding System which identify the supply associated with;

  • prosthetic;
  • a prosthetic device; or
  • orthotic.

Modifier AU is only applicable for the HCPCS codes: A4217 (Sterile water/saline, 500 ml), A4450 (Tape, nonwaterproof, per 18.. Read more..

Modifier AW

What is modifier AW? Item furnished in conjunction with a surgical dressing.

When to use an AW modifier? Use modifier AW for HCPCS codes or with Healthcare Common Procedure Coding System, which identifies the supply associated with a surgical dressing.

Modifier AW is only applicable for the HCPCS codes; A4450 (Tape, nonwaterproof, per 18 sq in), A4452 Tape, waterproof, per 18.. Read more..

Modifier AX

What is modifier AX? Item furnished in conjunction with dialysis services.

When to use an AX modifier? Use modifier AX for HCPCS codes or with Healthcare Common Procedure Coding System that identifies the supply associated with dialysis services.

Modifier AY

What is modifier AY? Item or service furnished to an ESRD patient that is not for the treatment of ESRD.

When to use an AY modifier? Use this modifier for Healthcare Common Procedure Coding System or HCPCS codes for services or items used for an ESRD patient. Don’t report his code for treatments of ESRD.

Modifier AZ

What is modifier AZ? For an electronic health record incentive payment, a physician provides a service in a dental health professional shortage area.

When to use an AZ modifier? Use modifier AZ for services provided by a health provider in zip code areas that are part of:

  • HPSA to obtain the electronic health record; or
  • EHR; or
  • a designated dental health professional shortage area; or
  • incentive payments.

Modifier AZ is not payable by Medicare.

Modifier BA

What is modifier BA? Item furnished in conjunction with parenteral, enteral nutrition (pen) services.

When to use a BA modifier? Use modifier BA if a health provider furnished a service or item in combination with parenteral, enteral nutrition (PEN) services.

Modifier BL

What is modifier BL? Special acquisition of blood and blood products.

When to use a BL modifier? Modifier BL can be used for HCPCS codes or the Healthcare Common Procedure Code System to report blood products or the actual blood.

Modifier BO

What is modifier BO? Orally administered nutrition, not by feeding tube.

When to use a BO modifier? This modifier could be appended to HCPCS codes or to the enteral nutrition Healthcare Common Procedure Code System if a health provider administered enteral nutrition products to a patient by mouth for enteral nutrition therapy.

Don’t report modifier BO for nutrition products administered by a feeding tube.

Modifier BP

What is modifier BP? The beneficiary has been informed of the purchase and rental options and has elected to purchase the item.

When to use a BP modifier? Use modifier BP to indicate that a patient has chosen to buy DME or durable medical equipment. The health provider needs to inform the patient about all the options available for either buying or renting the item.

Modifier BR

What is modifier BR? The beneficiary has been informed of the purchase and rental options and has elected to rent the item.

When to use a BR modifier? Modifier BR can be used for a code as an item where the beneficiary chooses to rent the item. The patient needs to be fully informed by the health provider about rental and buying options.

Modifier BU

What is modifier BU? The beneficiary has been informed of the purchase and rental options and, after 30 days, has not informed the supplier of his/her decision.

When to use a BU modifier? Modifier BU can be added to a code for durable medical equipment. The patient is fully informed about buying and rental options, but the beneficiary does not notify the supplier of their decision to buy or rent the items for 30 days or more.

Modifier CA

What is modifier CA? Procedure is payable only in the inpatient setting when performed emergently on an outpatient who expires before admission.

Modifier CB

What is modifier CB? Service ordered by a renal dialysis facility (RDF) physician as part of the ESRD beneficiary’s dialysis benefit, is not part of the composite rate, and is separately reimbursable.

Modifier CC

What is modifier CC? Procedure code change (use ‘CC’ when submitted procedure code was changed either for administrative reasons or because an incorrect code was filed).

Modifier CD

What is modifier CD? An AMCC test has been ordered by an ESRD facility or MCP physician that is part of the composite rate and is not separately billable.

Modifier CE

What is modifier CE? An AMCC test has been ordered by an ESRD facility or MCP physician that is a composite rate test but is beyond the normal frequency covered under the rate and is separately reimbursable based on medical necessity.

Modifier CF

What is modifier CF? An AMCC test has been ordered by an ESRD facility or MCP physician that is not part of the composite rate and is separately billable.

Modifier CG

What is modifier CG? Policy criteria applied.

Modifier CH

What is modifier CH? 0 percent impaired, limited or.. Read more..

Modifier CI

What is modifier CI? At least 1 percent but less than.. Read more..

Modifier CJ

What is modifier CJ? At least 20 percent but less than.. Read more..

Modifier CK

What is modifier CK? At least 40 percent but less than.. Read more..

Modifier CL

What is modifier CL? At least 60 percent but less than.. Read more..

Modifier CM

What is modifier CM? At least 80 percent but less than.. Read more..

Modifier CN

What is modifier CN? 100 percent impaired, limited or.. Read more..

Modifier CO

What is modifier CO? Outpatient occupational therapy services are furnished in whole or part by an occupational therapy assistant.

Modifier CQ

What is modifier CQ? Outpatient physical therapy services are furnished in whole or in part by a physical therapist assistant.

Modifier CR

What is modifier CR? Catastrophe/disaster-related.

Modifier CS

What is modifier CS? Cost-sharing waived for specified covid-19 testing-related services that result in an order from administration of a covid-19 test and/or used for cost-sharing waived preventive services furnished via telehealth in rural health clinics and federally qualified health centers during the covid-19 public health emergency.

Modifier CT

What is modifier CT? Computed tomography services are furnished using equipment that does not meet each attribute of the national electrical manufacturers association (NEMA) XR-29-2013 standard.

Modifier DA

What is modifier DA? Oral health assessment by a licensed health professional other than a dentist.

Modifier E1

What is modifier E1? Upper left eyelid.

Modifier E2

What is modifier E2? Lower left eyelid.

Modifier E3

What is modifier E3? Upper right eyelid.

Modifier E4

What is modifier E4? Lower right eyelid.

Modifier EA

What is modifier EA? Erythropoetic stimulating agent (ESA) is administered to treat anemia due to anti-cancer chemotherapy.

When to use an EA modifier? The EA modifier should only be reported when the ESA is given for anemia resulting from myelosuppressive anticancer chemotherapy in solid tumors, multiple myeloma, lymphoma, and.. Read more..

Modifier EB

What is modifier EB? Erythropoetic stimulating agent (ESA) is administered to treat anemia due to anti-cancer radiotherapy.

When to use an EB modifier? This modifier is used by CMS to gather information to determine the prevalence and severity of anemia associated with cancer therapy.

The clinical and hematologic responses to the institution of antianemia therapy, and.. Read more..

Modifier EC

What is modifier EC? Erythropoetic stimulating agent (ESA) is administered to treat anemia, not due to anti-cancer radiotherapy or anti-cancer chemotherapy.

When to use an EC modifier? Modifier EC should only be reported for those covered indications outlined in the LCD for J0881 and J0885 where the anemia being treated is non-chemo/radio induced.

FSCO has discovered that providers.. Read more..

Modifier ED

What is modifier ED? Hematocrit level has exceeded 39% (or hemoglobin level exceeded 13.0 g/dl) for three or more consecutive billing cycles immediately before and including the current cycle.

Modifier EE

What is modifier EE? Hematocrit level has not exceeded 39% (or hemoglobin level has not exceeded 13.0 g/dl) for three or more consecutive billing cycles immediately before and including the current cycle.

Modifier EJ

What is modifier EJ? Subsequent claims for a defined course of therapy, e.g., epo, sodium hyaluronate, infliximab.

Modifier EM

What is modifier EM? Emergency reserve supply (for ESRD benefit only).

Modifier EP

What is modifier EP? Service provided as part of medicaid early periodic screening diagnosis and treatment (EPSDT) program.

Modifier ER

What is modifier ER? Items and services are furnished by a provider-based, off-campus emergency department.

Modifier ET

What Is An ET Modifier? Emergency treatment.

When to use an ET modifier? Use this modifier to designate a dental procedure performed in an emergency.

Modifier EX

What is modifier EX? Expatriate beneficiary.

Modifier EY

What is modifier EY? No Physician or other licensed health care provider orders this service or item.

Modifier F1

What is modifier F1? Left hand. The second digit.

Modifier F2

What is modifier F2? Left hand. The third digit.

Modifier F3

What is modifier F3? Left hand. The fourth digit.

Modifier F4

What is modifier F4? Left hand. The fifth digit.

Modifier F5

What is modifier F5? Right hand. The thumb.

Modifier F6

What is modifier F6? Right hand. The second digit.

Modifier F7

What is modifier F7? Right hand. The third digit.

Modifier F8

What is modifier F8? Right hand. The fourth digit.

Modifier F9

What is modifier F9? Right hand. The fifth digit.

Modifier FA

What is modifier FA? Left hand. The thumb.

Modifier FB

What is modifier FB? Item provided without cost to provider, supplier, or practitioner, or full credit received for the replaced device (examples, but not limited to, covered under warranty, replaced due to defect, free samples).

Modifier FC

What is modifier FC? Partial credit received for the replaced device.

Modifier FP

What is modifier FP? Service provided as part of family planning program.

Modifier FQ

What is modifier FQ? The service was furnished using audio-only communication technology.

Modifier FR

What is modifier FR? The supervising practitioner was present through two-way audio/video communication technology.

Modifier FS

What is modifier FS? Split (or shared) evaluation and management visit.

Modifier FT

What is modifier FT? Unrelated E/M (Evaluation & Management) visit on the same day as another E/M visit or during a global procedure (preoperative, postoperative period, or on the same day as the procedure, as applicable).

Modifier FX

What is modifier FX? X-ray is taken using film.

Modifier FY

What is modifier FY? X-ray is taken using computed radiography technology/cassette-based imaging.

When to use a FY modifier? Providers must submit modifier FY with the X-ray CPT code for each X-ray taken using.. Read more..

Modifier G0

What is modifier G0? Telehealth services for diagnosis, evaluation, or treatment of symptoms of an acute stroke.

Modifier G1

What is modifier G1? Most recent URR of less than.. Read more..

Modifier G2

What is modifier G2? Most recent URR of 60% to.. Read more..

Modifier G3

What is modifier G3? Most recent URR of 65% to.. Read more..

Modifier G4

What is modifier G4? Most recent URR of 70% to.. Read more..

Modifier G5

What is modifier G5? Most recent URR of 75% or.. Read more..

Modifier G6

What is modifier G6? ESRD patient for whom less than seven dialysis sessions have been.. Read more..

Modifier G7

What is modifier G7? Pregnancy resulting from rape or incest or pregnancy certified by a Physician as life threatening.

Modifier G8

What is modifier G8? Monitored anesthesia care (mac) for deep, complex, complicated, or markedly invasive surgical procedures.

Modifier G9

What is modifier G9? Monitored anesthesia care for a patient with a history of severe cardio-pulmonary condition.

Modifier GA

What is modifier GA? Waiver of liability statement issued as required by payer policy, individual case.

When to use a GA modifier? Modifier GA can be reported if the Physician is confident that Medicare will deny service. Advance beneficiary notice issued by the Physician.. Read More..

Modifier GA

What is modifier GA? Claim being re-submitted for payment because it is no longer covered under a global payment demonstration.

Modifier GC

What is modifier GC? This service has been performed in part by a resident under the direction of a teaching Physician.

Modifier GD

What is modifier GD? Units of service exceed medically unlikely edit value and represent reasonable and necessary services.

Modifier GE

What is modifier GE? This service has been performed by a resident without the presence of a teaching physician under the primary care exception.

Modifier GF

What is modifier GF? Non-physician (e.g., nurse practitioner (NP), certified registered nurse anesthetist (CRNA), licensed registered nurse (CR ), clinical nurse specialist (CNS), physician assistant (PA)) services in a critical access hospital.

Modifier GG

What is modifier GG? Performance and payment of a screening mammogram and diagnostic mammogram on the same patient, same day.

Modifier GH

What is modifier GH? Diagnostic mammogram converted from screening mammogram on same day.

Modifier GJ

What is modifier GJ? Opted out physician or practitioner emergency or urgent service.

When to use a GJ modifier? Use the GJ modifier with the procedure code to identify services that were emergency or urgent when there.. Read more..

Modifier GK

What is modifier GK? Reasonable and necessary item/service associated with a GA or GZ modifier.

Modifier GL

What is modifier GL? A medically unnecessary upgrade is provided instead of a non-upgraded item, with no charge and no advance beneficiary notice (ABN).

Modifier GM

What is modifier GM? Multiple patients on one ambulance trip.

Modifier GN

What is modifier GN? Services are delivered under an outpatient speech language pathology plan of care.

Modifier GO

What is modifier GO? Services delivered under an outpatient occupational therapy plan of care.

Modifier GP

What is modifier GP? Services delivered under an outpatient physical therapy plan of care.

Modifier GQ

What is modifier GQ? Via asynchronous telecommunications system.

Modifier GR

What is modifier GR? This service was performed in whole or in part by a resident in a department of veterans affairs medical center or clinic, supervised in accordance with va policy.

Modifier GS

What is modifier GS? Dosage of erythropoietin stimulating agent has been reduced and maintained in response to hematocrit or hemoglobin level.

Modifier GT

What is modifier GT? Via interactive audio and video telecommunication systems.

Modifier GU

What is modifier GU? Waiver of liability statement issued as required by payer policy, routine notice.

Modifier GV

What is modifier GV? Attending physician not employed or paid under arrangement by the patient’s hospice provider.

Modifier GW

What is modifier GW? Service is not related to the hospice patient’s terminal condition.

Modifier GX

What is modifier GX? Notice of liability issued, voluntary under payer policy.

Modifier GY

What is modifier GY? Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit.

Modifier GZ

What is modifier GZ? Item or service expected to be denied as not reasonable and necessary.

When to use a GZ modifier? The GZ modifier must be used when physicians, practitioners, or suppliers want to indicate that they.. Read more..

Modifier H9

What is modifier H9? Court-ordered.

Modifier HA

What is modifier HA? Child/adolescent program.

Modifier HB

What is modifier HB? Adult program, non geriatric.

Modifier HC

What is modifier HC? Adult program, geriatric.

Modifier HD

What is modifier HD? Pregnant/parenting women’s program.

Modifier HE

What is modifier HE? Mental health program.

Modifier HF

What is modifier HF? Substance abuse program.

Modifier HG

What is modifier HG? Opioid addiction treatment program.

Modifier HH

What is modifier HH? Integrated mental health/substance abuse program.

Modifier HI

What is modifier HI? Integrated mental health and intellectual disability/developmental disabilities program.

Modifier HJ

What is modifier HJ? Employee assistance program.

Modifier HK

What is modifier HK? Specialized mental health programs for high-risk populations.

Modifier HL

What is modifier HL? Intern.

Modifier HM

What is modifier HM? Less than bachelor’s degree level.

Modifier HN

What is modifier HN? Bachelor’s degree level.

Modifier HO

What is modifier HO? Master’s degree level.

Modifier HP

What is modifier HP? Doctoral level.

Modifier HQ

What is modifier HQ? Group setting (for behavioral health use).

Modifier HR

What is modifier HR? Family/couple with the client present.

Modifier HS

What is modifier HS? Family/couple without the client present.

Modifier HT

What is modifier HT? Multidisciplinary team (for behavioral health use).

Modifier HU

What is modifier HU? Funded by a child welfare agency.

Modifier HV

What is modifier HV? Funded state addictions agency.

Modifier HW

What is modifier HW? Funded by state mental health agency.

Modifier HX

What is modifier HX? Funded by county/local agency.

Modifier HY

What is modifier HY? Funded by juvenile justice agency.

Modifier HZ

What is modifier HZ? Funded by criminal justice agency.

Modifier J1

What is modifier J1? Competitive acquisition program no-pay submission for a prescription number.

Modifier J2

What is modifier J2? Competitive acquisition program, restocking of emergency drugs after emergency administration.

Modifier J3

What is modifier J3? Competitive acquisition program (CAP), drug not available through cap as written, reimbursed under average sales price methodology.

Modifier J4

What is modifier J4? DMEPOS item subject to DMEPOS competitive bidding program that is furnished by a hospital upon discharge.

Modifier J5

What is modifier J5? Off-the-shelf orthotic subject to DMEPOS competitive bidding program that is furnished as part of a physical therapist or occupational therapist professional service.

Modifier JA

What is modifier JA? Administered intravenously.

Modifier JB

What is modifier JB? Administered subcutaneously.

Modifier JC

What is modifier JC? Skin substitute used as a graft.

Modifier JD

What is modifier JD? Skin substitute is not used as a graft.

Modifier JE

What is modifier JE? Administered via dialysate.

Modifier JG

What is modifier JG? Drug or biological acquired with 340b drug pricing program discount.

Modifier JW

What is modifier JW? Drug amount discarded/not administered to any patient.

Modifier K0

What is modifier K0? Lower extremity prosthesis functional level 0.

Modifier K1

What is modifier K1? Lower extremity prosthesis functional level 1.

Modifier K2

What is modifier K2? Lower extremity prosthesis functional level 2.

Modifier K3

What is modifier K3? Lower extremity prosthesis functional level 3.

Modifier K4

What is modifier K4? Lower extremity prosthesis functional level 4.

Modifier KA

What is modifier KA? Add on option/accessory for a wheelchair.

Modifier KB

What is modifier KB? The beneficiary requested an upgrade for ABN. More than four modifiers identified on the claim

Modifier KC

What is modifier KC? Replacement of special power wheelchair interface.

Modifier KD

What is modifier KD? Drug or Biological infused through implanted DME.

Modifier KE

What is modifier KE? Bid under round one of the DMEPOS competitive bidding program for use with non-competitive bid base equipment.

Modifier KF

What is modifier KF? Item designated by FDA as Class III device.

When to use a KF modifier? Modifier KF is a pricing modifier. The HCPCS codes for DME designated as class III devices by the FDA are identified on the DMEPOS fee schedule by the presence of the KF modifier.

The KF Modifier is applicable only for.. Read more..

Modifier KG

What is modifier KG? DMEPOS item subject to DMEPOS competitive bidding program number 1.

Modifier KH

What is modifier KH? DMEPOS item. Initial claim. Purchase or first month rental.

Modifier KI

What is modifier KI? DMEPOS item. Second or third month rental.

Modifier KJ

What is modifier KJ? DMEPOS item. Parenteral enteral nutrition (PEN) pump or capped rental. Months 4 to 15.

Modifier KK

What is modifier KK? DMEPOS item subject to DMEPOS competitive bidding program number 2.

Modifier KL

What is modifier KL? DMEPOS item delivered via mail.

When to use a KL modifier? Contract suppliers must use the KL Modifier on all claims for diabetic supply codes furnished via mail order.

Non-contract suppliers furnish mail-order diabetic supplies to beneficiaries who do not live in.. Read more..

Modifier KM

What is modifier KM? Replacement of facial prosthesis including new impression/moulage.

When to use a KM modifier? The KM Modifier and KN Modifier are to be used on claims for the replacement of items identified by codes L8040 thru L8047 that are furnished on or after January 1, 2005.

Payment for codes L8040 thru L8047 is based on the.. Read more..

Modifier KN

What is modifier KN? Replacement of facial prosthesis including new impression/moulage.

When to use a KN modifier? KM Modifier and KN Modifier are used on claims to replace items identified by HCPCS codes L8040 until L8047.

Payment for codes L8040 thru L8047 is based on the.. Read more..

Modifier KO

What is modifier KO? Single drug unit dose formulation.

Modifier KP

What is modifier KP? The first drug of a multiple drug unit dose formulation.

Modifier KQ

What is modifier KQ? Second or subsequent drug of a multiple drug unit dose formulation.

Modifier KR

What Is A KR Modifier? Rental item, billing for partial month.

Modifier KS

What is modifier KS? Glucose monitor supply for a diabetic beneficiary not treated with insulin.

Modifier KT

What is modifier KT? Beneficiary resides in a competitive bidding area and travels outside that competitive bidding area and receives a competitive bid item.

Modifier KU

What is modifier KU? DMEPOS item subject to DMEPOS competitive bidding program number 3.

Modifier KV

What is modifier KV? DMEPOS item subject to DMEPOS competitive bidding program that is furnished as part of a professional service.

Modifier KW

What is modifier KW? DMEPOS item subject to DMEPOS competitive bidding program number 4.

Modifier KX

What is modifier KX? Requirements specified in the medical policy have been met.

program number 4.

Modifier KY

What is modifier KY? DMEPOS item subject to DMEPOS competitive bidding program number 5.

Modifier KZ

What is modifier KZ? New coverage not implemented by managed care.

Modifier LC

What is modifier LC? Left anterior descending coronary artery.

Modifier LD

What is modifier LD? Left anterior descending coronary artery.

Modifier LL

What is modifier LL? Lease/rental. Use this modifier when DME equipment rental is to be applied against the purchase price.

Modifier LM

What is modifier LM? Left main coronary artery.

Modifier LR

What is modifier LR? Laboratory round trip.

Modifier LS

What is modifier LS? FDA-monitored intraocular lens implant.

Modifier LT

What is modifier LT? Left side. This modifier is used to identify procedures performed on the left side of the body.

Modifier M2

What is modifier M2? Medicare secondary payer (MSP).

Modifier MA

What is modifier MA? The ordering professional is not required to consult a clinical decision support mechanism due to service being rendered to a patient with a suspected or confirmed emergency medical condition.

Modifier MB

What is modifier MB? The ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of insufficient internet access.

Modifier MC

What is modifier MC? The ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of electronic health records or clinical decision support mechanism vendor issues.

Modifier MD

What is modifier MD? The ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of extreme and uncontrollable circumstances.

Modifier ME

What is modifier ME? The order for this service adheres to appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional.

Modifier MF

What is modifier MF? The order for this service does not adhere to the appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional.

Modifier MG

What is modifier MG? The order for this service does not have applicable appropriate use criteria in the qualified clinical decision support mechanism consulted by the ordering professional.

Modifier MH

What is modifier MH? Unknown if ordering professional consulted a clinical decision support mechanism for this service, related information was not provided to the furnishing professional or provider.

Modifier MS

What is modifier MS? Six-month maintenance and servicing fee for reasonable and necessary parts and labor which are not covered under any manufacturer or supplier warranty.

Modifier NB

What is modifier NB? Nebulizer system. Any type. FDA-cleared for use with a specific drug.

Modifier NR

What is modifier NR? New when rented. Use modifier NR when new DME at the rental time is subsequently purchased.

Modifier NU

What is modifier NU? New equipment (DME).

Modifier P1

What is modifier P1? A normal healthy patient.

Modifier P2

What is modifier P2? A patient with mild systemic disease.

Modifier P3

What is modifier P3? A patient with severe systemic disease.

Modifier P4

What is modifier P4? A patient with a severe systemic disease that is a constant threat to life.

Modifier P5

What is modifier P5? A moribund patient is not expected to survive without the operation.

Modifier P6

What is modifier P6? A declared brain-dead patient whose organs are being removed for donor purposes.

Modifier PA

What is modifier PA? Surgical or other invasive procedure on the wrong body part.

Modifier PB

What is modifier PB? Surgical or other invasive procedure on the wrong patient.

Modifier PC

What is modifier PC? Wrong surgery or other invasive procedure on a patient.

Modifier PD

What is modifier PD? Diagnostic or related non-diagnostic item or service provided in a wholly owned or operated entity to a patient admitted as an inpatient within three days.

Modifier PI

What is modifier PI? Positron emission tomography (PET) or pet/computed tomography (CPT) to inform the initial treatment strategy of tumors that are biopsy proven or strongly suspected of being cancerous based on another diagnostic testing.

Modifier PL

What is modifier PL? Progressive addition lenses.

Modifier PM

What is modifier PM? Post mortem.

Modifier PN

What is modifier PN? Non-excepted service is provided at an off-campus, outpatient, provider-based hospital department.

Modifier PO

What is modifier PO? Excepted service provided at a hospital’s off-campus, outpatient, provider-based department.

Modifier PS

What is modifier PS? Positron emission tomography (PET) or pet/computed tomography (CT) to inform the subsequent treatment strategy of cancerous tumors when the beneficiary’s treating physician determines that the pet study is needed to inform subsequent anti-tumor strategy.

Modifier PT

What is modifier PT? Colorectal cancer screening test; converted to diagnostic test or other procedure.

Modifier Q0

What is modifier Q0? An investigational clinical service that is provided in a clinical research study that is in an approved clinical research study.

Modifier Q1

What is modifier Q1? A routine clinical service that is provided in a clinical research study that is in an approved clinical research study.

Modifier Q2

What is modifier Q2? Demonstration procedure or service.

Modifier Q3

What is modifier Q3? Live kidney donor surgery and related services.

Modifier Q4

What is modifier Q4? Service for ordering/referring physician qualifies as a service exemption.

Modifier Q5

What is modifier Q5? Service furnished under a reciprocal billing arrangement by a:

  • substitute physician;
  • by a substitute physical therapist furnishing outpatient physical therapy services in a:
    • health professional shortage area;
    • a medically underserved area; or
    • a rural area.

Modifier Q6

What is modifier Q6? A service furnished under a fee-for-time compensation arrangement by a;

  • substitute physician; or
  • by a substitute physical therapist furnishing outpatient physical therapy services in a:
    • health professional shortage area:
    • a medically underserved area; or
    • a rural area.

Modifier Q7

What is modifier Q7? One class A finding.

Modifier Q8

What is modifier Q8? Two class B findings.

Modifier Q9

What is modifier Q9? One class B and two class C findings.

Modifier QA

What is modifier QA? Prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ; the average of the two amounts is less than one liter per minute (LPM).

Modifier QB

What is modifier QB? Prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ; the average of the two amounts exceeds four liters per minute (LPM), and portable oxygen is prescribed.

Modifier QC

What is modifier QC? Single channel monitoring.

Modifier QD

What is modifier QD? Recording and storage in solid state memory by a digital recorder.

Modifier QE

What is modifier QE? The prescribed amount of stationary oxygen at rest is less than one liter per minute (LPM).

Modifier QF

What is modifier QF? The prescribed amount of stationary oxygen at rest exceeds four liters per minute (LPM), and portable oxygen is prescribed.

Modifier QG

What is modifier QG? The prescribed amount of stationary oxygen at rest is greater than 4 Liters per minute (LPM).

Modifier QH

What is modifier QH? An oxygen conserving device is being used with an oxygen delivery system.

Modifier QJ

What is modifier QJ? Services or items provided to a prisoner or patient in state or local custody. However, as applicable, the state or local government meets the requirements in 42 CFR 411.4 (B).

Modifier QK

What is modifier QK? The medical direction of two, three, or four concurrent anesthesia procedures involves qualified individuals.

Modifier QL

What is modifier QL? The patient was pronounced dead after an ambulance was called.

Modifier QM

What is modifier QL? An ambulance service is provided under an arrangement by a provider of services.

Modifier QN

What is modifier QN? An ambulance service is furnished directly by a provider of services.

Modifier QP

What is modifier QP? Documentation shows that the laboratory test(s) was ordered individually or as a CPT-recognized panel other than automated profile codes CPT 80002 – CPT 80019, CPT G0058, CPT G0059, and CPT G0060.

Modifier QQ

What is modifier QQ? The ordering professional consulted a qualified clinical decision support mechanism for this service, and the related data was provided to the furnishing professional.

When to use modifier QQ? Modifier QQ can be used when the furnishing professional is aware of the result of the ordering professional’s consultation with a CDSM for that patient.

Modifier QQ is reported on the same claim line as the CPT code for advanced diagnostic imaging.. Read more..

Modifier QR

What is modifier QR? Prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ, and the average of the two amounts is greater than 4 liters per minute (LPM)

Modifier QS

What is modifier QS? Monitored anesthesia care services.

Modifier QT

What is modifier QT? Recording and storage on tape by an analog tape recorder.

Modifier QW

What is modifier QW? CLIA Waived Test. Effective October 1, 1996, all new waived tests are being assigned a CPT code (instead of a temporary five-digit G- or Q-code).

Modifier QX

What is modifier QX? CRNA service with medical direction by a physician.

Modifier QY

What is modifier QY? Medical direction of one certified registered nurse anesthetist (CRNA) by an anesthesiologist

Modifier QZ

What is modifier QZ? CRNA service without medical direction by a Physician.

Modifier RA

What is modifier RA? Replacement of a DME, prosthetic or orthotic item.

Modifier RB

What is modifier RB? Replacement of a part of a DME, prosthetic or orthotic item furnished as part of a repair.

Modifier RC

What is modifier RC? Right coronary artery.

Modifier RD

What is modifier RD? Drug provided to the beneficiary. Not administered ‘incident-to’.

Modifier RE

What is modifier RE? Furnished in full compliance with a fda-mandated risk evaluation and mitigation strategy (REMS).

Modifier RI

What is modifier RI? Ramus intermedius coronary artery.

Modifier RR

What is modifier RR? Rental. Use modifier RR when DME is to be rented.

Modifier RT

What is modifier RT? Right Side. The RT modifier is used to identify procedures performed on the right side of the body.

Modifier SA

What is modifier SA? A nurse practitioner renders service in collaboration with a Physician.

Modifier SB

What is modifier SB? Nurse midwife.

Modifier SC

What is modifier SC? Medically necessary service or supply.

Modifier SD

What is modifier SD? Services provided by registered nurse with specialized, highly technical home infusion training.

Modifier SE

What is modifier SE? State and/or federally-funded programs/services.

Modifier SF

What is modifier SF? Second opinion ordered by a professional review organization (pro) per section 9401, p.l. 99-272 (100% reimbursement – no medicare deductible or coinsurance).

Modifier SG

What is modifier SG? Ambulatory surgical center (ASC) facility service.

Modifier SH

What is modifier SH? A second concurrently administered infusion therapy.

Modifier SJ

What is modifier SJ? A third or more concurrently administered infusion therapy.

Modifier SK

What is modifier SK? Member of a high-risk population. Use modifier SK only with codes for immunization).

Modifier SL

What is modifier SL? State supplied vaccine.

Modifier SM

What is modifier SM? A 2nd surgical opinion.

Modifier SN

What is modifier SN? A 3rd surgical opinion.

Modifier SQ

What is modifier SQ? An item ordered by home health.

Modifier SS

What is modifier SS? The home infusion services are provided in the infusion suite of the iv therapy provider.

Modifier ST

What is modifier ST? Related to trauma or injury.

Modifier SU

What is modifier SU? Procedure performed in physician’s office. Use this modifier to denote the use of facility and equipment.

Modifier SV

What is modifier SV? Pharmaceuticals delivered to patient’s home but not utilized.

Modifier SW

What is modifier SW? The services are provided by a certified diabetic educator.

Modifier SY

What is modifier SY? Persons who are in close contact with members of high-risk populations. Use modifier SY only with codes for immunization.

Modifier T1

What is modifier T1? Left foot. The 2nd digit.

Modifier T2

What is modifier T2? Left foot. The 3rd digit

Modifier T3

What is modifier T3? Left foot. The 4th digit.

Modifier T4

What is modifier T4? Left foot. The 5th digit.

Modifier T5

What is modifier T5? Right foot. The great toe.

Modifier T6

What is modifier T6? Right foot. The 2nd digit.

Modifier T7

What is modifier T7? Right foot. The 3rd digit.

Modifier T8

What is modifier T8? Right foot. The 4th digit.

Modifier T9

What is modifier T9? Right foot. The 5th digit.

Modifier TA

What is modifier TA? Left foot. The great toe.

Modifier TB

What is modifier TB? Drug or biological acquired with 340b drug pricing program discount. This modifier is used for informational purposes.

Modifier TC

What is modifier TC? Technical component only. Use modifier TC to indicate the technical part of a diagnostic procedure performed.

Modifier TD

What is modifier TD? Registered Nurse (RN). USe this modifier for behavioral health use.

Modifier TE

What is modifier TE? Licensed Practical Nurse (LPN). Use this modifier for behavioral health use.

Modifier TF

What is modifier TF? Intermediate level of care.

Modifier TG

What is modifier TG? Complex and/or high-tech level of care.

Modifier TH

What is modifier TH? Obstetrical treatment and/or services. Postpartum or prenatal.

Modifier TJ

What Is A TJ Modifier? Program group. Adolescents and/or children. Use this modifier for enhancement payment for foster care children screening exams. 

Modifier TK

What Is A TK Modifier? Extra member or passenger. Non-ambulance transportation.

Modifier TL

What is modifier TL? Early intervention/individualized family service plan (IFSP).

Modifier TM

What is modifier TM? Individualized education program (IEP).

Modifier TN

What is modifier TN? Rural/outside providers’ customary service area.

Modifier TP

What is modifier TP? Medical transport. Unloaded vehicle.

Modifier TQ

What is modifier TQ? Basic life support transport by a volunteer ambulance provider.

Modifier TR

What is modifier TR? School-based individualized education program (IEP) services provided outside the public school district responsible for a student.

Modifier TS

What is modifier TS? Follow-up service.

Modifier TT

What is modifier TT? Individualized service is provided to more than one patient in the same setting.

Modifier TU

What is modifier TU? Special payment rate for overtime.

Modifier TV

What is modifier TV? Special payment rates for holidays or weekends.

Modifier TW

What is modifier TW? Back-up equipment.

Modifier U1

What is modifier U1? Medicaid level of care one. The level is defined by each state.

Modifier U2

What is modifier U2? Medicaid level of care two. The level is defined by each state..

Modifier U3

What is modifier U3? Medicaid level of care three. The level is defined by each state.

Modifier U4

What is modifier U4? Medicaid level of care four. The level is defined by each state.

Modifier U5

What is modifier U5? Medicaid level of care five. The level is defined by each state.

Modifier U6

What is modifier U6? Medicaid level of care six. The level is defined by each state.

Modifier U7

What is modifier U7? Medicaid level of care seven. The level is defined by each state.

Modifier U8

What is modifier U8? Medicaid level of care eight. The level is defined by each state.

Modifier U9

What is modifier U9? Medicaid level of care nine. The level is defined by each state.

Modifier UA

What is modifier UA? Medicaid level of care ten. The level is defined by each state.

Modifier UB

What is modifier UB? Medicaid level of care eleven. The level is defined by each state.

Modifier UC

What is modifier UC? Medicaid level of care twelve. The level is defined by each state.

Modifier UD

What is modifier UD? Medicaid level of care thirteen. The level is defined by each state.

Modifier UE

What is modifier UE? Used durable medical equipment.

Modifier UF

What is modifier UF? Services provided in the morning.

Modifier UG

What is modifier UG? Services provided in the afternoon.

Modifier UH

What is modifier UH? Services provided in the evening.

Modifier UJ

What is modifier UJ? Services provided at night.

Modifier UK

What is modifier UK? Services provided on behalf of the client to someone other than the client. This modifier can be used for collateral relationship.

Modifier UN

What is modifier UN? Two patients for portable X-rays.

Modifier UP

What is modifier UP? Three patients for portable X-rays.

Modifier UQ

What is modifier UQ? Four patients for portable X-rays.

Modifier UR

What is modifier UR? Five patients for portable X-rays.

Modifier US

What is modifier US? Six or more patients for portable X-rays.

Modifier V1

What is modifier V1? Demonstration modifier one.

Modifier V2

What is modifier V2? Demonstration modifier two.

Modifier V3

What is modifier V3? Demonstration modifier three.

Modifier V4

What is modifier V4? Demonstration modifier four.

Modifier V5

What is modifier V5? Vascular catheter. Alone or with any other vascular access.

Modifier V6

What is modifier V6? Arteriovenous graft or other vascular access. Vascular catheter is not included.

Modifier V7

What is modifier V7? Arteriovenous fistula in use with two needles.

Modifier VM

What is modifier VM? Medicare diabetes prevention program (MDPP) virtual make-up session.

Modifier VP

What is modifier VP? Aphakic patient.

Modifier X1

What is modifier X1? Continuous or broad services.

Modifier X2

What is modifier X2? Continuous or focused services.

Modifier X3

What is modifier X3? Episodic or broad services.

Modifier X4

What is modifier X4? Episodic or focused services.

Modifier X5

What is modifier X5? Diagnostic services requested by another clinician.

Modifier XE

What is modifier XE? Separate encounter.

When to use a XE modifier? Modifier XE can be used for a service that is distinct because it occurred during.. Read more..

Modifier XS

What is modifier XS? Separate structure.

When to use a XS modifier? Modifier XS can be used for a service that is distinct because it was performed.. Read more..

Modifier XP

What is modifier XP? Separate practitioner.

When to use a XP modifier? Modifier XP can be used for a service that is distinct because it was performed by.. Read more..

Modifier XU

What is modifier XU? Unusual non-overlapping service.

When to use a XU modifier? Modifier XU can be used for a service that is.. Read more..

Note: Please check the respective insurance guidelines for appropriate usage of Modifiers to avoid denials. 

Are you looking for the CPT modifier list? You can find it here.

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