| A2 | Dressing for two wounds |
| A1 | Dressing for one wound |
| A3 | Dressing for three wounds |
| A4 | Dressing for four wounds |
| A5 | Dressing for five wounds |
| A9 | Dressing for nine or more wounds |
| A8 | Dressing for eight wounds |
| AA | Anesthesia services performed personally by anesthesiologist |
| AB | Audiology service furnished personally by an audiologist without a physician/npp order for non-acute hearing assessment unrelated to disequilibrium, or hearing aids, or examinations for the purpose of prescribing, fitting, or changing hearing aids; service may be performed once every 12 months, per beneficiary |
| AD | Medical supervision by a physician: more than four concurrent anesthesia procedures |
| AE | Registered dietician |
| AF | Specialty physician |
| AG | Primary physician |
| AH | Clinical psychologist |
| AI | Principal physician of record |
| AJ | Clinical social worker |
| AK | Non participating physician |
| AM | Physician, team member service |
| A6 | Dressing for six wounds |
| AP | Determination of refractive state was not performed in the course of diagnostic ophthalmological examination |
| A7 | Dressing for seven wounds |
| AR | Physician provider services in a physician scarcity area |
| AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery |
| AT | Acute treatment (this modifier should be used when reporting service 98940, 98941, 98942) |
| AU | Item furnished in conjunction with a urological, ostomy, or tracheostomy supply |
| AW | Item furnished in conjunction with a surgical dressing |
| AX | Item furnished in conjunction with dialysis services |
| AV | Item furnished in conjunction with a prosthetic device, prosthetic or orthotic |
| AY | Item or service furnished to an esrd patient that is not for the treatment of esrd |
| AZ | Physician providing a service in a dental health professional shortage area for the purpose of an electronic health record incentive payment |
| AO | Alternate payment method declined by provider of service |
| AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) |
| BP | The beneficiary has been informed of the purchase and rental options and has elected to purchase the item |
| BA | Item furnished in conjunction with parenteral enteral nutrition (pen) services |
| BL | Special acquisition of blood and blood products |
| BR | The beneficiary has been informed of the purchase and rental options and has elected to rent the item |
| BO | Orally administered nutrition, not by feeding tube |
| 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 |
| CF | Amcc test has been ordered by an esrd facility or mcp physician that is not part of the composite rate and is separately billable |
| CG | Policy criteria applied |
| CD | Amcc test has been ordered by an esrd facility or mcp physician that is part of the composite rate and is not separately billable |
| CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) |
| CA | Procedure payable only in the inpatient setting when performed emergently on an outpatient who expires prior to admission |
| 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 |
| CE | 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 |
| CJ | At least 20 percent but less than 40 percent impaired, limited or restricted |
| CK | At least 40 percent but less than 60 percent impaired, limited or restricted |
| CO | Outpatient occupational therapy services furnished in whole or in part by an occupational therapy assistant |
| CM | At least 80 percent but less than 100 percent impaired, limited or restricted |
| CP | Adjunctive service related to a procedure assigned to a comprehensive ambulatory payment classification (c-apc) procedure, but reported on a different claim
Terminated December 31, 2017. |
| CL | At least 60 percent but less than 80 percent impaired, limited or restricted |
| CN | 100 percent impaired, limited or restricted |
| CQ | Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant |
| CT | Computed tomography services furnished using equipment that does not meet each of the attributes of the national electrical manufacturers association (nema) xr-29-2013 standard |
| CR | Catastrophe/disaster related |
| CS | Cost-sharing waived for specified covid-19 testing-related services that result in and order for or 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 |
| CH | 0 percent impaired, limited or restricted |
| CI | At least 1 percent but less than 20 percent impaired, limited or restricted |
| EB | Erythropoietic stimulating agent (esa) administered to treat anemia due to anti-cancer radiotherapy |
| EA | Erythropoietic stimulating agent (esa) administered to treat anemia due to anti-cancer chemotherapy |
| E2 | Lower left, eyelid |
| E1 | Upper left, eyelid |
| E4 | Lower right, eyelid |
| EC | Erythropoietic stimulating agent (esa) administered to treat anemia not due to anti-cancer radiotherapy or anti-cancer chemotherapy |
| EE | Hematocrit level has not exceeded 39% (or hemoglobin level has not exceeded 13.0 g/dl) for 3 or more consecutive billing cycles immediately prior to and including the current cycle |
| ED | Hematocrit level has exceeded 39% (or hemoglobin level has exceeded 13.0 g/dl) for 3 or more consecutive billing cycles immediately prior to and including the current cycle |
| E3 | Upper right, eyelid |
| ER | Items and services furnished by a provider-based, off-campus emergency department |
| EP | Service provided as part of medicaid early periodic screening diagnosis and treatment (epsdt) program |
| ET | Emergency services |
| EX | Expatriate beneficiary |
| EY | No physician or other licensed health care provider order for this item or service |
| EJ | Subsequent claims for a defined course of therapy, e.g., epo, sodium hyaluronate, infliximab |
| EM | Emergency reserve supply (for esrd benefit only) |
| F7 | Right hand, third digit |
| F3 | Left hand, fourth digit |
| F4 | Left hand, fifth digit |
| F2 | Left hand, third digit |
| F6 | Right hand, second digit |
| F1 | Left hand, second digit |
| F5 | Right hand, thumb |
| FA | Left hand, thumb |
| F8 | Right hand, fourth digit |
| F9 | Right hand, fifth digit |
| FB | Item provided without cost to provider, supplier or practitioner, or full credit received for replaced device (examples, but not limited to, covered under warranty, replaced due to defect, free samples) |
| FT | Unrelated evaluation and management (e/m) 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). (report when an e/m visit is furnished within the global period but is unrelated, or when one or more additional e/m visits furnished on the same day are unrelated) |
| FY | X-ray taken using computed radiography technology/cassette-based imaging |
| FR | The supervising practitioner was present through two-way, audio/video communication technology |
| FS | Split (or shared) evaluation and management visit |
| FX | X-ray taken using film |
| FQ | The service was furnished using audio-only communication technology |
| FP | Service provided as part of family planning program |
| FC | Partial credit received for replaced device |
| G1 | Most recent urr reading of less than 60 |
| G2 | Most recent urr reading of 60 to 64.9 |
| G6 | Esrd patient for whom less than six dialysis sessions have been provided in a month |
| G5 | Most recent urr reading of 75 or greater |
| G0 | Telehealth services for diagnosis, evaluation, or treatment, of symptoms of an acute stroke |
| G3 | Most recent urr reading of 65 to 69.9 |
| G4 | Most recent urr reading of 70 to 74.9 |
| GA | Waiver of liability statement issued as required by payer policy, individual case |
| G7 | Pregnancy resulted from rape or incest or pregnancy certified by physician as life threatening |
| G9 | Monitored anesthesia care for patient who has history of severe cardio-pulmonary condition |
| GC | This service has been performed in part by a resident under the direction of a teaching physician |
| G8 | Monitored anesthesia care (mac) for deep complex, complicated, or markedly invasive surgical procedure |
| GB | Claim being re-submitted for payment because it is no longer covered under a global payment demonstration |
| GF | Non-physician (e.g. nurse practitioner (np), certified registered nurse anesthetist (crna), certified registered nurse (crn), clinical nurse specialist (cns), physician assistant (pa)) services in a critical access hospital |
| GG | Performance and payment of a screening mammogram and diagnostic mammogram on the same patient, same day |
| GH | Diagnostic mammogram converted from screening mammogram on same day |
| GJ | "opt out" physician or practitioner emergency or urgent service |
| GL | Medically unnecessary upgrade provided instead of non-upgraded item, no charge, no advance beneficiary notice (abn) |
| GK | Reasonable and necessary item/service associated with a ga or gz modifier |
| GN | Services delivered under an outpatient speech language pathology plan of care |
| GM | Multiple patients on one ambulance trip |
| GP | Services delivered under an outpatient physical therapy plan of care |
| GQ | Via asynchronous telecommunications system |
| GO | Services delivered under an outpatient occupational therapy plan of care |
| GS | Dosage of erythropoietin stimulating agent has been reduced and maintained in response to hematocrit or hemoglobin level |
| 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 |
| GT | Via interactive audio and video telecommunication systems |
| GU | Waiver of liability statement issued as required by payer policy, routine notice |
| GV | Attending physician not employed or paid under arrangement by the patient's hospice provider |
| GW | Service not related to the hospice patient's terminal condition |
| 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 |
| GX | Notice of liability issued, voluntary under payer policy |
| GZ | Item or service expected to be denied as not reasonable and necessary |
| GE | This service has been performed by a resident without the presence of a teaching physician under the primary care exception |
| GD | Units of service exceeds medically unlikely edit value and represents reasonable and necessary services
Terminated December 31, 2019. |
| HH | Integrated mental health/substance abuse program |
| HF | Substance abuse program |
| HG | Opioid addiction treatment program |
| HE | Mental health program |
| HC | Adult program, geriatric |
| HD | Pregnant/parenting women's program |
| HB | Adult program, non geriatric |
| HA | Child/adolescent program |
| HM | Less than bachelor degree level |
| HJ | Employee assistance program |
| HI | Integrated mental health and intellectual disability/developmental disabilities program |
| HK | Specialized mental health programs for high-risk populations |
| HN | Bachelors degree level |
| HL | Intern |
| H9 | Court-ordered |
| HQ | Group setting |
| HR | Family/couple with client present |
| HS | Family/couple without client present |
| HT | Multi-disciplinary team |
| HU | Funded by child welfare agency |
| HW | Funded by state mental health agency |
| HV | Funded state addictions agency |
| HX | Funded by county/local agency |
| HZ | Funded by criminal justice agency |
| HY | Funded by juvenile justice agency |
| HO | Masters degree level |
| HP | Doctoral level |
| JE | Administered via dialysate |
| JG | Drug or biological acquired with 340b drug pricing program discount, reported for informational purposes
Terminated December 31, 2024. |
| JF | Compounded drug
Terminated June 30, 2015. |
| J1 | Competitive acquisition program no-pay submission for a prescription number |
| JD | Skin substitute not used as a graft |
| 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 |
| J3 | Competitive acquisition program (cap), drug not available through cap as written, reimbursed under average sales price methodology |
| J4 | Dmepos item subject to dmepos competitive bidding program that is furnished by a hospital upon discharge |
| JZ | Zero drug amount discarded/not administered to any patient |
| JK | One month supply or less of drug or biological |
| JB | Administered subcutaneously |
| JC | Skin substitute used as a graft |
| JL | Three month supply of drug or biological |
| J2 | Competitive acquisition program, restocking of emergency drugs after emergency administration |
| JA | Administered intravenously |
| JW | Drug amount discarded/not administered to any patient |
| KI | Dmepos item, second or third month rental |
| KK | Dmepos item subject to dmepos competitive bidding program number 2 |
| KJ | Dmepos item, parenteral enteral nutrition (pen) pump or capped rental, months four to fifteen |
| KE | Bid under round one of the dmepos competitive bidding program for use with non-competitive bid base equipment |
| KG | Dmepos item subject to dmepos competitive bidding program number 1 |
| KH | Dmepos item, initial claim, purchase or first month rental |
| K4 | Lower extremity prosthesis functional level 4 - has the ability or potential for prosthetic ambulation that exceeds the basic ambulation skills, exhibiting high impact, stress, or energy levels, typical of the prosthetic demands of the child, active adult, or athlete. |
| KF | Item designated by fda as class iii device |
| K0 | Lower extremity prosthesis functional level 0 - does not have the ability or potential to ambulate or transfer safely with or without assistance and a prosthesis does not enhance their quality of life or mobility. |
| KA | Add on option/accessory for wheelchair |
| KD | Drug or biological infused through dme |
| KB | Beneficiary requested upgrade for abn, more than 4 modifiers identified on claim |
| KC | Replacement of special power wheelchair interface |
| K2 | Lower extremity prosthesis functional level 2 - has the ability or potential for ambulation with the ability to traverse low level environmental barriers such as curbs, stairs or uneven surfaces. typical of the limited community ambulator. |
| K1 | Lower extremity prosthesis functional level 1 - has the ability or potential to use a prosthesis for transfers or ambulation on level surfaces at fixed cadence. typical of the limited and unlimited household ambulator. |
| K3 | Lower extremity prosthesis functional level 3 - has the ability or potential for ambulation with variable cadence. typical of the community ambulator who has the ability to transverse most environmental barriers and may have vocational, therapeutic, or exercise activity that demands prosthetic utilization beyond simple locomotion. |
| KL | Dmepos item delivered via mail |
| KO | Single drug unit dose formulation |
| KP | First drug of a multiple drug unit dose formulation |
| KQ | Second or subsequent drug of a multiple drug unit dose formulation |
| KR | Rental item, billing for partial month |
| KT | Beneficiary resides in a competitive bidding area and travels outside that competitive bidding area and receives a competitive bid item |
| KS | Glucose monitor supply for diabetic beneficiary not treated with insulin |
| KV | Dmepos item subject to dmepos competitive bidding program that is furnished as part of a professional service |
| KW | Dmepos item subject to dmepos competitive bidding program number 4 |
| KZ | New coverage not implemented by managed care |
| KX | Requirements specified in the medical policy have been met |
| KU | Dmepos item subject to dmepos competitive bidding program number 3 |
| KY | Dmepos item subject to dmepos competitive bidding program number 5 |
| KM | Replacement of facial prosthesis including new impression/moulage |
| KN | Replacement of facial prosthesis using previous master model |
| LC | Left circumflex coronary artery |
| L1 | Provider attestation that the hospital laboratory test(s) is not packaged under the hospital opps
Terminated December 31, 2016. |
| LM | Left main coronary artery |
| LL | Lease/rental (use the 'll' modifier when dme equipment rental is to be applied against the purchase price) |
| LU | Fractionated payment |
| LR | Laboratory round trip |
| LS | Fda-monitored intraocular lens implant |
| LT | Left side (used to identify procedures performed on the left side of the body) |
| LD | Left anterior descending coronary artery |
| 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
Terminated December 31, 2024. |
| ME | The order for this service adheres to appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional
Terminated December 31, 2024. |
| 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
Terminated December 31, 2024. |
| 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
Terminated December 31, 2024. |
| MA | 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
Terminated December 31, 2024. |
| MD | Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of extreme and uncontrollable circumstances
Terminated December 31, 2024. |
| MC | Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of electronic health record or clinical decision support mechanism vendor issues
Terminated December 31, 2024. |
| MS | Six month maintenance and servicing fee for reasonable and necessary parts and labor which are not covered under any manufacturer or supplier warranty |
| M2 | Medicare secondary payer (msp) |
| MB | Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of insufficient internet access
Terminated December 31, 2024. |
| NR | New when rented (use the 'nr' modifier when dme which was new at the time of rental is subsequently purchased) |
| NB | Nebulizer system, any type, fda-cleared for use with specific drug |
| N2 | Group 2 oxygen coverage criteria met |
| N3 | Group 3 oxygen coverage criteria met |
| N1 | Group 1 oxygen coverage criteria met |
| NU | New equipment |
| PD | Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days |
| PL | Progressive addition lenses |
| PN | Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital |
| PI | Positron emission tomography (pet) or pet/computed tomography (ct) to inform the initial treatment strategy of tumors that are biopsy proven or strongly suspected of being cancerous based on other diagnostic testing |
| P2 | A patient with mild systemic disease |
| PM | Post mortem |
| P5 | A moribund patient who is not expected to survive without the operation |
| PB | Surgical or other invasive procedure on wrong patient |
| P4 | A patient with severe systemic disease that is a constant threat to life |
| P1 | A normal healthy patient |
| PC | Wrong surgery or other invasive procedure on patient |
| P6 | A declared brain-dead patient whose organs are being removed for donor purposes |
| PA | Surgical or other invasive procedure on wrong body part |
| PT | Colorectal cancer screening test; converted to diagnostic test or other procedure |
| P3 | A patient with severe systemic disease |
| PO | Excepted service provided at an off-campus, outpatient, provider-based department of a hospital |
| 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 |
| QF | Prescribed amount of stationary oxygen while at rest exceeds 4 liters per minute (lpm) and portable oxygen is prescribed |
| QC | Single channel monitoring |
| QG | Prescribed amount of stationary oxygen while at rest is greater than 4 liters per minute (lpm) |
| QB | Prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts exceeds 4 liters per minute (lpm) and portable oxygen is prescribed |
| Q4 | Service for ordering/referring physician qualifies as a service exemption |
| Q5 | Service furnished under a reciprocal billing 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 |
| Q7 | One class a finding |
| Q2 | Demonstration procedure/service |
| QD | Recording and storage in solid state memory by a digital recorder |
| Q0 | Investigational clinical service provided in a clinical research study that is in an approved clinical research study |
| QA | Prescribed amounts of stationary oxygen for daytime use while at rest and nighttime use differ and the average of the two amounts is less than 1 liter per minute (lpm) |
| Q9 | One class b and two class c findings |
| Q6 | 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 |
| 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) |
| QE | Prescribed amount of stationary oxygen while at rest is less than 1 liter per minute (lpm) |
| Q8 | Two class b findings |
| Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study |
| Q3 | Live kidney donor surgery and related services |
| QH | Oxygen conserving device is being used with an oxygen delivery system |
| QM | Ambulance service provided under arrangement by a provider of services |
| QN | Ambulance service furnished directly by a provider of services |
| QT | Recording and storage on tape by an analog tape recorder |
| 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) |
| QS | Monitored anesthesia care service |
| QZ | Crna service: without medical direction by a physician |
| QQ | Ordering professional consulted a qualified clinical decision support mechanism for this service and the related data was provided to the furnishing professional
Terminated December 31, 2024. |
| QW | Clia waived test |
| QY | Medical direction of one certified registered nurse anesthetist (crna) by an anesthesiologist |
| QP | Documentation is on file showing that the laboratory test(s) was ordered individually or ordered as a cpt-recognized panel other than automated profile codes 80002-80019, g0058, g0059, and g0060. |
| QX | Crna service: with medical direction by a physician |
| QK | Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals |
| QL | Patient pronounced dead after ambulance called |
| RC | Right coronary artery |
| RD | Drug provided to beneficiary, but not administered "incident-to" |
| RB | Replacement of a part of a dme, orthotic or prosthetic item furnished as part of a repair |
| RA | Replacement of a dme, orthotic or prosthetic item |
| RT | Right side (used to identify procedures performed on the right side of the body) |
| RE | Furnished in full compliance with fda-mandated risk evaluation and mitigation strategy (rems) |
| RR | Rental (use the 'rr' modifier when dme is to be rented) |
| RI | Ramus intermedius coronary artery |
| SE | State and/or federally-funded programs/services |
| SG | Ambulatory surgical center (asc) facility service |
| SD | Services provided by registered nurse with specialized, highly technical home infusion training |
| SM | Second surgical opinion |
| SJ | Third or more concurrently administered infusion therapy |
| SH | Second concurrently administered infusion therapy |
| SB | Nurse midwife |
| SC | Medically necessary service or supply |
| SF | Second opinion ordered by a professional review organization (pro) per section 9401, p.l. 99-272 (100% reimbursement - no medicare deductible or coinsurance) |
| SN | Third surgical opinion |
| SA | Nurse practitioner rendering service in collaboration with a physician |
| SZ | Habilitative services
Terminated December 31, 2017. |
| SU | Procedure performed in physician's office (to denote use of facility and equipment) |
| ST | Related to trauma or injury |
| SK | Member of high risk population (use only with codes for immunization) |
| SW | Services provided by a certified diabetic educator |
| SV | Pharmaceuticals delivered to patient's home but not utilized |
| SS | Home infusion services provided in the infusion suite of the iv therapy provider |
| SY | Persons who are in close contact with member of high-risk population (use only with codes for immunization) |
| SQ | Item ordered by home health |
| SL | State supplied vaccine |
| TE | Lpn/lvn |
| TM | Individualized education program (iep) |
| T7 | Right foot, third digit |
| TL | Early intervention/individualized family service plan (ifsp) |
| TF | Intermediate level of care |
| T1 | Left foot, second digit |
| TC | Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles |
| TG | Complex/high tech level of care |
| TH | Obstetrical treatment/services, prenatal or postpartum |
| TJ | Program group, child and/or adolescent |
| T8 | Right foot, fourth digit |
| TA | Left foot, great toe |
| T5 | Right foot, great toe |
| TD | Rn |
| T3 | Left foot, fourth digit |
| T6 | Right foot, second digit |
| TB | Drug or biological acquired with 340b drug pricing program discount, reported for informational purposes |
| TK | Extra patient or passenger, non-ambulance |
| T2 | Left foot, third digit |
| T4 | Left foot, fifth digit |
| T9 | Right foot, fifth digit |
| TQ | Basic life support transport by a volunteer ambulance provider |
| TT | Individualized service provided to more than one patient in same setting |
| TR | School-based individualized education program (iep) services provided outside the public school district responsible for the student |
| TS | Follow-up service |
| TV | Special payment rates, holidays/weekends |
| TU | Special payment rate, overtime |
| TW | Back-up equipment |
| TP | Medical transport, unloaded vehicle |
| TN | Rural/outside providers' customary service area |
| U9 | Medicaid level of care 9, as defined by each state |
| U5 | Medicaid level of care 5, as defined by each state |
| U4 | Medicaid level of care 4, as defined by each state |
| U7 | Medicaid level of care 7, as defined by each state |
| U2 | Medicaid level of care 2, as defined by each state |
| U6 | Medicaid level of care 6, as defined by each state |
| U8 | Medicaid level of care 8, as defined by each state |
| UD | Medicaid level of care 13, as defined by each state |
| UH | Services provided in the evening |
| UJ | Services provided at night |
| U1 | Medicaid level of care 1, as defined by each state |
| U3 | Medicaid level of care 3, as defined by each state |
| UB | Medicaid level of care 11, as defined by each state |
| UK | Services provided on behalf of the client to someone other than the client (collateral relationship) |
| UN | Two patients served |
| UE | Used durable medical equipment |
| UC | Medicaid level of care 12, as defined by each state |
| UP | Three patients served |
| UQ | Four patients served |
| UR | Five patients served |
| UG | Services provided in the afternoon |
| UA | Medicaid level of care 10, as defined by each state |
| UF | Services provided in the morning |
| US | Six or more patients served |
| V1 | Demonstration modifier 1 |
| V3 | Demonstration modifier 3 |
| V6 | Arteriovenous graft (or other vascular access not including a vascular catheter) |
| V4 | Demonstration modifier 4 |
| V2 | Demonstration modifier 2 |
| VM | Medicare diabetes prevention program (mdpp) virtual make-up session |
| VP | Aphakic patient |
| V8 | Infection present
Terminated March 31, 2012. |
| V9 | No infection present
Terminated March 31, 2012. |
| V5 | Vascular catheter (alone or with any other vascular access) |
| V7 | Arteriovenous fistula only (in use with two needles) |
| X1 | Continuous/broad services: for reporting services by clinicians, who provide the principal care for a patient, with no planned endpoint of the relationship; services in this category represent comprehensive care, dealing with the entire scope of patient problems, either directly or in a care coordination role; reporting clinician service examples include, but are not limited to: primary care, and clinicians providing comprehensive care to patients in addition to specialty care |
| XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner |
| XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
| X3 | Episodic/broad services: for reporting services by clinicians who have broad responsibility for the comprehensive needs of the patient that is limited to a defined period and circumstance such as a hospitalization; reporting clinician service examples include but are not limited to the hospitalist's services rendered providing comprehensive and general care to a patient while admitted to the hospital |
| X2 | Continuous/focused services: for reporting services by clinicians whose expertise is needed for the ongoing management of a chronic disease or a condition that needs to be managed and followed with no planned endpoint to the relationship; reporting clinician service examples include but are not limited to: a rheumatologist taking care of the patient's rheumatoid arthritis longitudinally but not providing general primary care services |
| XE | Separate encounter, a service that is distinct because it occurred during a separate encounter |
| XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
| X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician |
| X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period |
| ZA | Novartis/sandoz
Terminated March 31, 2018. |
| ZB | Pfizer/hospira
Terminated March 31, 2018. |
| ZC | Merck/samsung bioepis
Terminated March 31, 2018. |