Modifiers and their Role in Billing

Modifiers are used to modify payment of a procedure code, assist in determining appropriate coverage, or otherwise identify the detail on the claim. The use of modifiers ensures the appropriate reimbursement by the insurer.

Modifiers are entered in box 24 D on the HCFA-1500 (CMS-1500) claim form or UB 92 (CMS 1450).
For the most current list of modifiers, refer to the current CPT or HCPCS Code book.

Note: The modifiers are updated on a yearly basis, and the tables are supplied to each RPMS site by the IHS Office of Information Technology (OIT). It is the responsibility of each Area IT to install the updated tables.