Modifiers to be used for Part B
| Program | Category | Modifier Code | Description |
| PART – B | Physician Quality Reporting | 1P | Physician Quality Reporting System – Performance measure exclusion modifier due to medical reasons. |
| PART – B | Surgical | 22 | Unusual procedural services. |
| PART – B | E/M | 24 | Evaluation and Management (E/M) – Unrelated E/M service by the same physician during a postoperative period. |
| PART – B | E/M | 25 | Significant, separately identifiable Evaluation and Management (E/M) service by the same physician on the same day of the procedure or other service. |
| PART – B | Radiology/Pathology | 26 | Professional component. |
| PART – B | Physician Quality Reporting | 2P | Physician Quality Reporting System – Performance measure exclusion modifier due to patient reasons. |
| PART – B | Physician Quality Reporting | 3P | Physician Quality Reporting System – Performance measure exclusion modifier due to system reasons. |
| PART – B | Coding | 50 | Bilateral procedure. |
| PART – B | Surgical | 51 | Multiple procedures. |
| PART – B | Coding | 52 | Reduced services. |
| PART – B | Coding | 53 | Discontinued procedure. |
| PART – B | Surgical | 54 | Surgical care only. |
| PART – B | Surgical | 55 | Postoperative management only. |
| PART – B | Surgical | 56 | Preoperative management only. |
| PART – B | E/M | 57 | Evaluation and Management (E/M) – Decision for surgery. |
| PART – B | Surgical | 58 | Staged or related procedure or service by the same physician during the postoperative period. |
| PART – B | Coding | 59 | National Correct Coding Initiative (NCCI) – Distinct procedural service. |
| PART – B | Surgical | 62 | Two surgeons. |
| PART – B | Surgical | 66 | Surgical team. |
| PART – B | ASC | 73 | Ambulatory Surgical Center (ASC) – Discontinued procedure prior to administration of anesthesia. |
| PART – B | ASC | 74 | Ambulatory Surgical Center (ASC) – Discontinued procedure after administration of anesthesia. |
| PART – B | Coding | 76 | Repeat procedure by same physician. |
| PART – B | Coding | 77 | Repeat procedure by another physician. |
| PART – B | Surgical | 78 | Return to the operative room for a related procedure during the postoperative period. |
| PART – B | Surgical | 79 | Unrelated procedure or service by the same physician during the postoperative period. |
| PART – B | Surgical | 80 | Assistant surgeon. |
| PART – B | Surgical | 81 | Minimum assistant surgeon. |
| PART – B | Surgical | 82 | Assistant surgeon (when qualified resident surgeon not available). |
| PART – B | Physician Quality Reporting | 8P | Physician Quality Reporting System – Performance measure reporting modifier – action not performed, reason not otherwise specified. |
| PART – B | Laboratory | 90 | Referenced (outside) laboratory. |
| PART – B | Laboratory | 91 | Repeat clinical diagnostic laboratory test. |
| PART – B | Coding | 99 | Multiple modifiers. |
| PART – B | Anesthesia | AA | Services performed personally by an anesthesiologist. |
| PART – B | Anesthesia | AD | Medical supervision by a physician, more than four concurrent procedures. |
| PART – B | Psychiatric | AH | Clinical psychologist. |
| PART – B | E/M | AI | Principal physician of record. |
| PART – B | Psychiatric | AJ | Clinical social worker. |
| PART – B | HPSA/PSA | AQ | Physician providing a service in a Health Professional Shortage Area (HPSA). |
| PART – B | HPSA/PSA | AR | Physician provided service in a Physician Scarcity Area (PSA). |
| PART – B | Surgical | AS | Physician Assistant (PA), Clinical Nurse Specialist (CNS) or Nurse Practitioner (NP) services for assistant-at-surgery. |
| PART – B | Chiropractic | AT | Acute treatment. |
| PART – B | Outpatient Hospital | AY | Item or service furnished to an ESRD patient that is not for the treatment of ESRD. |
| PART – B | Health Professional Shortage Area (HPSA) | AZ | Physician providing a service in a dental health professional shortage area for the purpose of an Electronic Health Record (EHR) incentive payment. |
| PART – B | ESRD | CB | Service ordered by a RDF physician as part End Stage Renal Disease (ESRD) beneficiary’s dialysis benefit. |
| PART – B | Coding | CC | Procedure code change. |
| PART – B | Catastrophe/Disaster | CR | Catastrophe/Disaster-related claims. |
| PART – B | Disaster-related claims | CS | Gulf oil spill 2010 related. |
| PART – B | Anatomical | E1 | Upper left eyelid. |
| PART – B | Anatomical | E2 | Lower left eyelid. |
| PART – B | Anatomical | E3 | Upper right eyelid. |
| PART – B | Anatomical | E4 | Lower right eyelid. |
| PART – B | Drugs | EA | Erythropoiesis Stimulating Agent (ESA) – Anemia, chemo-induced. |
| PART – B | Drugs | EB | Erythropoiesis Stimulating Agent (ESA) – Anemia, radio-induced. |
| PART – B | Drugs | EC | Erythropoiesis Stimulating Agent (ESA) – Anemia, non-chemo/radio. |
| PART – B | Anatomical | F1 | Left hand, second digit. |
| PART – B | Anatomical | F2 | Left hand, third digit. |
| PART – B | Anatomical | F3 | Left hand, fourth digit. |
| PART – B | Anatomical | F4 | Left hand, fifth digit. |
| PART – B | Anatomical | F5 | Right hand, thumb. |
| PART – B | Anatomical | F6 | Right hand, second digit. |
| PART – B | Anatomical | F7 | Right hand, third digit. |
| PART – B | Anatomical | F8 | Right hand, fourth digit. |
| PART – B | Anatomical | F9 | Right hand, fifth digit. |
| PART – B | Anatomical | FA | Left hand, thumb. |
| PART – B | ASC | FB | Ambulatory Surgical Center (ASC) – Item provided without cost to provider, supplier or practitioner, or full credit received for replaced device. |
| PART – B | ASC | FC | Ambulatory Surgical Center (ASC) – Partial credit received for replaced device. |
| PART – B | Anesthesia | G8 | Monitored Anesthesia Care (MAC) for deep complex, complicated or markedly invasive surgical procedure. |
| PART – B | Anesthesia | G9 | Monitored Anesthesia Care (MAC) for patient who has history of severe cardiopulmonary condition. |
| PART – B | ABN | GA | Waiver of liability statement issued, as required by payer policy. |
| PART – B | Resident | GC | Service performed in part by a resident under the direction of a teaching physician. |
| PART – B | Resident | GE | Service performed by a resident without the presence of a teaching physician under the primary care exception. |
| PART – B | Radiology | GG | Performance and payment of a screening mammography and diagnostic mammography on the same patient, same day. |
| PART – B | Opt-Out | GJ | “Opt-Out” physician or practitioner service provided in an emergency or urgent service. |
| PART – B | Ambulance | GM | Multiple patients on one ambulance trip. |
| PART – B | PT/OT | GN | Physical/Occupational Therapy (PT/OT) – Services delivered under an outpatient speech language pathology plan of care. |
| PART – B | PT/OT | GO | Physical/Occupational Therapy (PT/OT) – Services delivered under an outpatient occupational therapy plan of care. |
| PART – B | PT/OT | GP | Physical/Occupational Therapy (PT/OT) – Services delivered under an outpatient physical therapy plan of care. |
| PART – B | Telehealth | GT | Via interactive audio and video telecommunications system. |
| PART – B | Hospice | GV | Attending physician not employed or paid under arrangement by the patient’s hospice provider. |
| PART – B | Hospice | GW | Service not related to the hospice patient’s terminal condition. |
| PART – B | Excluded | GY | Item or service statutorily excluded or does not meet the definition of any Medicare benefit. |
| PART – B | ABN | GZ | Advance Beneficiary Notice (ABN) was not signed by the beneficiary. |
| PART – B | CAP | J1 | “No pay” Competitive Acquisition Program (CAP)modifier for drug line. |
| PART – B | CAP | J2 | Competitive Acquisition Program (CAP) emergency re-supply. |
| PART – B | CAP | J3 | Competitive Acquisition Program (CAP) “Furnish as Written.” |
| PART – B | Drugs | JW | Drug amount discarded/not administered to any patient. |
| PART – B | Drugs | KD | Drug or biological infused through Durable Medical Equipment (DME). |
| PART – B | Medical Policy | KX | Requirements specified in the medical policy have been met. |
| PART – B | Anatomical | LC | Left circumflex coronary artery. |
| PART – B | Anatomical | LD | Left anterior descending coronary artery. |
| PART – B | Laboratory | LR | Laboratory round trip. |
| PART – B | Eye | LS | FDA-monitored Intraocular Lens (IOL) implant. |
| PART – B | Anatomical | LT | Left side. |
| PART – B | CAP | MS | Competitive Acquisition Program (CAP) Medicare secondary payer. |
| PART – B | Anesthesia | P1 | Physical Status – A normal healthy patient. |
| PART – B | Anesthesia | P2 | Physical Status – A patient with mild systemic disease. |
| PART – B | Anesthesia | P3 | Physical Status – A patient with severe systemic disease. |
| PART – B | Anesthesia | P4 | Physical Status – A patient with severe systemic disease that is a constant threat to life. |
| PART – B | Anesthesia | P5 | Physical Status – A moribund patient who is not expected to survive without the operation. |
| PART – B | Anesthesia | P6 | Physical Status – A declared brain-dead patient whose organs are being removed for donor purposes. |
| PART – B | Wrong Procedure | PA | Surgery wrong body part. Wrong surgical or other invasive procedures performed on a patient. |
| PART – B | Wrong Procedure | PB | Surgery wrong patient. Wrong surgical or other invasive procedures performed on a patient |
| PART – B | Wrong Procedure | PC | Wrong surgery on patient. Wrong surgical or other invasive procedures performed on a patient. |
| PART – B | Radiology | PI | Positron Emission Tomography (PET) or PET/Computed Tomography (CT). |
| PART – B | Radiology | PS | Positron Emission Tomography (PET) or PET/Computed Tomography (CT). |
| PART – B | Surgical | PT | Colorectal cancer screening test; converted to diagnostic test or other procedure. |
| PART – B | Clinical Research Studies | Q0 | Investigational clinical service provided in a clinical research study that is in an approved clinical research study. |
| PART – B | Clinical Research Studies | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study. |
| PART – B | Kidney | Q3 | Live kidney donor surgery and related services. |
| PART – B | Physician | Q5 | Service furnished by a substitute physician under a reciprocal billing arrangement. |
| PART – B | Physician | Q6 | Services furnished by a locum tenens physician. |
| PART – B | Footcare | Q7 | One class A finding. |
| PART – B | Footcare | Q8 | Two class B findings. |
| PART – B | Footcare | Q9 | One class B and two class C findings. |
| PART – B | Prison/Custody | QJ | Services/items provided to a prisoner or patient in state or local custody; however, the state or local government, as applicable, meets the requirements in 42 CFR 411.4(b). For outpatient claims, providers should append modifier QJ on all lines with a line item date of service during the incarceration period. All associated charges should be billed as non-covered. |
| PART – B | Anesthesia | QK | Medical direction of two, three or four concurrent procedures. |
| PART – B | Ambulance | QL | Patient pronounced dead after ambulance called (do not use origin and destination modifiers, only QL). |
| PART – B | Anesthesia | QS | Monitored Anesthesia Care (MAC) services. |
| PART – B | Laboratory | QW | Clinical Laboratory Improvement Amendments (CLIA) waived test. |
| PART – B | Anesthesia | QX | Certified Registered Nurse Anesthetist (CRNA) service with medical direction by a physician. |
| PART – B | Anesthesia | QY | Medical direction of one Certified Registered Nurse Anesthetist (CRNA) by an anesthesiologist. |
| PART – B | Anesthesia | QZ | Certified Registered Nurse Anesthetist (CRNA) service without medical direction by a physician. |
| PART – B | DME | RA | Replacement of a Durable Medical Equipment (DME), orthotic or prosthetic item. |
| PART – B | Anatomical | RC | Right coronary artery. |
| PART – B | Anatomical | RT | Right side. |
| PART – B | ASC | SG | Ambulatory Surgical Center (ASC) – Facility service. |
| PART – B | Anatomical | T1 | Left foot, second digit. |
| PART – B | Anatomical | T2 | Left foot, third digit. |
| PART – B | Anatomical | T3 | Left foot, fourth digit. |
| PART – B | Anatomical | T4 | Left foot, fifth digit. |
| PART – B | Anatomical | T5 | Right foot, great toe. |
| PART – B | Anatomical | T6 | Right foot, second digit. |
| PART – B | Anatomical | T7 | Right foot, third digit. |
| PART – B | Anatomical | T8 | Right foot, fourth digit. |
| PART – B | Anatomical | T9 | Right foot, fifth digit. |
| PART – B | Anatomical | TA | Left foot, great toe. |
| PART – B | Radiology/Pathology | TC | Technical component. |
| PART – B | Radiology | UN | Portable X-Ray Supplier – Two patients served. |
| PART – B | Radiology | UP | Portable X-Ray Supplier – Three patients served. |
| PART – B | Radiology | UQ | Portable X-Ray Supplier – Four patients served. |
| PART – B | Radiology | UR | Portable X-Ray Supplier – Five patients served. |
| PART – B | Radiology | US | Portable X-Ray Supplier – Six patients served. |
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