1P Performance Measure Exclusion Modifier due to Medical Reasons:~~Includes:~Not indicated (absence of organ/limb), already received/performed,other)–Contraindicated (patient allergic history, potential adverse drug interaction,other)–Other medical reasons
22 Increased Procedural Services
23 Unusual Anesthesia
24 Unrelated Evaluation and Management Service by the Same Physician During a Postoperative Period
25 Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service
26 Professional Component
27 Multiple Outpatient Hospital E/M Encounters on the Same Date
2P Performance MeasureExclusion Modifier due to Patient Reasons:~Includes:~~Patient declined~Economic, social, or religious reasons~Other patient reasons
32 Mandated Services
33 Preventive Services
3P Performance Measure Exclusion Modifier due to System Reasons:~Includes:~~Resources to perform the services not available~Insurance coverage/payor-related limitations~Other reasons attributable to health care delivery system
47 Anesthesia by Surgeon
50 Bilateral Procedure
51 Multiple Procedures
52 Reduced Services
53 Discontinued Procedure
54 Surgical Care Only
55 Postoperative Management Only
56 Preoperative Management Only
57 Decision for Surgery
58 Staged or Related Procedure or Service by the Same Physician During the Postoperative Period
59 Distinct Procedural Service
62 Two Surgeons
63 Procedure Performed on Infants less than 4 kg
66 Surgical Team
73 Discontinued Outpatient Hospital/Ambulatory Surgery Center (ASC) Procedure Prior to the Administration of Anesthesia
74 Discontinued Outpatient Hospital/Ambulatory Surgery Center (ASC) Procedure After Administration of Anesthesia
76 Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional
77 Repeat Procedure or Service by Another Physician or Other Qualified Health Care Professional
78 Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Health Care Professional Following Initial Procedure for a Related Procedure During the Postoperative Period
79 Unrelated Procedure or Service by the Same Physician During the Postoperative Period
80 Assistant Surgeon
81 Minimum Assistant Surgeon
82 Assistant Surgeon (when qualified resident surgeon not available)
8P Performance measure reporting modifier – action not performed, reason not otherwise specified
90 Reference (Outside) Laboratory
91 Repeat Clinical Diagnostic Laboratory Test
92 Alternative Laboratory Platform Testing
93 Synchronous Telemedicine Service Rendered Via Telephone or Other Real-Time Interactive Audio-Only Telecommunications System
95 Synchronous Telemedicine Service Rendered Via a Real-Time Interactive Audio and Video Telecommunications System
96 Habilitative Services
97 Rehabilitative Services
99 Multiple Modifiers
A1 Dressing for one wound
A2 Dressing for two wounds
A3 Dressing for three wounds
A4 Dressing for four wounds
A5 Dressing for five wounds
A6 Dressing for six wounds
A7 Dressing for seven wounds
A8 Dressing for eight wounds
A9 Dressing for nine or more 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
AO Alternate payment method declined by provider of service
AP Determination of refractive state was not performed in the course of diagnostic ophthalmological examination
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
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
AV Item furnished in conjunction with a prosthetic device, prosthetic or orthotic
AW Item furnished in conjunction with a surgical dressing
AX Item furnished in conjunction with dialysis services
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
BA Item furnished in conjunction with parenteral enteral nutrition (pen) services
BL Special acquisition of blood and blood products
BO Orally administered nutrition, not by feeding tube
BP The beneficiary has been informed of the purchase and rental options and has elected to purchase the item
BR The beneficiary has been informed of the purchase and rental options and has elected to rent the item
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
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
CC Procedure code change (use ‘cc’ when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
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
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
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
CH 0 percent impaired, limited or restricted
CI At least 1 percent but less than 20 percent impaired, limited or restricted
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
CL At least 60 percent but less than 80 percent impaired, limited or restricted
CM At least 80 percent but less than 100 percent impaired, limited or restricted
CN 100 percent impaired, limited or restricted
CO Outpatient occupational therapy services furnished in whole or in part by an occupational therapy assistant
CQ Outpatient physical therapy services furnished in whole or in part by a physical therapist assistant
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
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
DA Oral health assessment by a licensed health professional other than a dentist
E1 Upper left, eyelid
E2 Lower left, eyelid
E3 Upper right, eyelid
E4 Lower right, eyelid
EA Erythropoetic stimulating agent (esa) administered to treat anemia due to anti-cancer chemotherapy
EB Erythropoetic stimulating agent (esa) administered to treat anemia due to anti-cancer radiotherapy
EC Erythropoetic stimulating agent (esa) administered to treat anemia not due to anti-cancer radiotherapy or anti-cancer chemotherapy
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
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
EJ Subsequent claims for a defined course of therapy, e.g., epo, sodium hyaluronate, infliximab
EM Emergency reserve supply (for esrd benefit only)
EP Service provided as part of medicaid early periodic screening diagnosis and treatment (epsdt) program
ER Items and services furnished by a provider-based, off-campus emergency department
ET Emergency services
EX Expatriate beneficiary
EY No physician or other licensed health care provider order for this item or service
F1 Left hand, second digit
F2 Left hand, third digit
F3 Left hand, fourth digit
F4 Left hand, fifth digit
F5 Right hand, thumb
F6 Right hand, second digit
F7 Right hand, third digit
F8 Right hand, fourth digit
F9 Right hand, fifth digit
FA Left hand, thumb
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)
FC Partial credit received for replaced device
FP Service provided as part of family planning program
FQ The service was furnished using audio-only communication technology
FR The supervising practitioner was present through two-way, audio/video communication technology
FS Split (or shared) evaluation and management visit
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)
FX X-ray taken using film
FY X-ray taken using computed radiography technology/cassette-based imaging
G0 Telehealth services for diagnosis, evaluation, or treatment, of symptoms of an acute stroke
G1 Most recent urr reading of less than 60
G2 Most recent urr reading of 60 to 64.9
G3 Most recent urr reading of 65 to 69.9
G4 Most recent urr reading of 70 to 74.9
G5 Most recent urr reading of 75 or greater
G6 Esrd patient for whom less than six dialysis sessions have been provided in a month
G7 Pregnancy resulted from rape or incest or pregnancy certified by physician as life threatening
G8 Monitored anesthesia care (mac) for deep complex, complicated, or markedly invasive surgical procedure
G9 Monitored anesthesia care for patient who has history of severe cardio-pulmonary condition
GA Waiver of liability statement issued as required by payer policy, individual case
GB Claim being re-submitted for payment because it is no longer covered under a global payment demonstration
GC This service has been performed in part by a resident under the direction of a teaching physician
GE This service has been performed by a resident without the presence of a teaching physician under the primary care exception
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
GK Reasonable and necessary item/service associated with a ga or gz modifier
GL Medically unnecessary upgrade provided instead of non-upgraded item, no charge, no advance beneficiary notice (abn)
GM Multiple patients on one ambulance trip
GN Services delivered under an outpatient speech language pathology plan of care
GO Services delivered under an outpatient occupational therapy plan of care
GP Services delivered under an outpatient physical therapy plan of care
GQ Via asynchronous telecommunications system
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
GS Dosage of erythropoietin stimulating agent has been reduced and maintained in response to hematocrit or hemoglobin level
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
GX Notice of liability issued, voluntary under payer policy
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
GZ Item or service expected to be denied as not reasonable and necessary
H9 Court-ordered
HA Child/adolescent program
HB Adult program, non geriatric
HC Adult program, geriatric
HD Pregnant/parenting women’s program
HE Mental health program
HF Substance abuse program
HG Opioid addiction treatment program
HH Integrated mental health/substance abuse program
HI Integrated mental health and intellectual disability/developmental disabilities program
HJ Employee assistance program
HK Specialized mental health programs for high-risk populations
HL Intern
HM Less than bachelor degree level
HN Bachelors degree level
HO Masters degree level
HP Doctoral level
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
HV Funded state addictions agency
HW Funded by state mental health agency
HX Funded by county/local agency
HY Funded by juvenile justice agency
HZ Funded by criminal justice agency
J1 Competitive acquisition program no-pay submission for a prescription number
J2 Competitive acquisition program, restocking of emergency drugs after emergency administration
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
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
JA Administered intravenously
JB Administered subcutaneously
JC Skin substitute used as a graft
JD Skin substitute not used as a graft
JE Administered via dialysate
JG Drug or biological acquired with 340b drug pricing program discount, reported for informational purposes
JK One month supply or less of drug or biological
JL Three month supply of drug or biological
JW Drug amount discarded/not administered to any patient
JZ Zero drug amount discarded/not administered to any patient
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.
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.
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.
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.
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.
KA Add on option/accessory for wheelchair
KB Beneficiary requested upgrade for abn, more than 4 modifiers identified on claim
KC Replacement of special power wheelchair interface
KD Drug or biological infused through dme
KE Bid under round one of the dmepos competitive bidding program for use with non-competitive bid base equipment
KF Item designated by fda as class iii device
KG Dmepos item subject to dmepos competitive bidding program number 1
KH Dmepos item, initial claim, purchase or first month rental
KI Dmepos item, second or third month rental
KJ Dmepos item, parenteral enteral nutrition (pen) pump or capped rental, months four to fifteen
KK Dmepos item subject to dmepos competitive bidding program number 2
KL Dmepos item delivered via mail
KM Replacement of facial prosthesis including new impression/moulage
KN Replacement of facial prosthesis using previous master model
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
KS Glucose monitor supply for diabetic beneficiary not treated with insulin
KT Beneficiary resides in a competitive bidding area and travels outside that competitive bidding area and receives a competitive bid item
KU Dmepos item subject to dmepos competitive bidding program number 3
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
KX Requirements specified in the medical policy have been met
KY Dmepos item subject to dmepos competitive bidding program number 5
KZ New coverage not implemented by managed care
LC Left circumflex coronary artery
LD Left anterior descending coronary artery
LL Lease/rental (use the ‘ll’ modifier when dme equipment rental is to be applied against the purchase price)
LM Left main coronary artery
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)
LU Fractionated payment of car-t therapy
M2 Medicare secondary payer (msp)
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
MB Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of insufficient internet access
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
MD Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of extreme and uncontrollable circumstances
ME The order for this service adheres to appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional
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
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
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
MS Six month maintenance and servicing fee for reasonable and necessary parts and labor which are not covered under any manufacturer or supplier warranty
NB Nebulizer system, any type, fda-cleared for use with specific drug
NR New when rented (use the ‘nr’ modifier when dme which was new at the time of rental is subsequently purchased)
NU New equipment
P1 A normal healthy patient
P2 A patient with mild systemic disease
P3 A patient with severe systemic disease
P4 A patient with severe systemic disease that is a constant threat to life
P5 A moribund patient who is not expected to survive without the operation
P6 A declared brain-dead patient whose organs are being removed for donor purposes
PA Surgical or other invasive procedure on wrong body part
PB Surgical or other invasive procedure on wrong patient
PC Wrong surgery or other invasive procedure on patient
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
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
PL Progressive addition lenses
PM Post mortem
PN Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital
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
PT Colorectal cancer screening test; converted to diagnostic test or other procedure
Q0 Investigational clinical service provided in a clinical research study that is in an approved clinical research study
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
Q2 Demonstration procedure/service
Q3 Live kidney donor surgery and related services
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
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
Q7 One class a finding
Q8 Two class b findings
Q9 One class b and two class c findings
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)
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
QC Single channel monitoring
QD Recording and storage in solid state memory by a digital recorder
QE Prescribed amount of stationary oxygen while at rest is less than 1 liter per minute (lpm)
QF Prescribed amount of stationary oxygen while at rest exceeds 4 liters per minute (lpm) and portable oxygen is prescribed
QG Prescribed amount of stationary oxygen while at rest is greater than 4 liters per minute (lpm)
QH Oxygen conserving device is being used with an oxygen delivery system
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)
QK Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals
QL Patient pronounced dead after ambulance called
QM Ambulance service provided under arrangement by a provider of services
QN Ambulance service furnished directly by a provider of services
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.
QQ Ordering professional consulted a qualified clinical decision support mechanism for this service and the related data was provided to the furnishing professional
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
QT Recording and storage on tape by an analog tape recorder
QW Clia waived test
QX Crna service: with medical direction by a physician
QY Medical direction of one certified registered nurse anesthetist (crna) by an anesthesiologist
QZ Crna service: without medical direction by a physician
RA Replacement of a dme, orthotic or prosthetic item
RB Replacement of a part of a dme, orthotic or prosthetic item furnished as part of a repair
RC Right coronary artery
RD Drug provided to beneficiary, but not administered “”incident-to
RE Furnished in full compliance with fda-mandated risk evaluation and mitigation strategy (rems)
RI Ramus intermedius coronary artery
RR Rental (use the ‘rr’ modifier when dme is to be rented)
RT Right side (used to identify procedures performed on the right side of the body)
SA Nurse practitioner rendering service in collaboration with a physician
SB Nurse midwife
SC Medically necessary service or supply
SD Services provided by registered nurse with specialized, highly technical home infusion training
SE State and/or federally-funded programs/services
SF Second opinion ordered by a professional review organization (pro) per section 9401, p.l. 99-272 (100% reimbursement – no medicare deductible or coinsurance)
SG Ambulatory surgical center (asc) facility service
SH Second concurrently administered infusion therapy
SJ Third or more concurrently administered infusion therapy
SK Member of high risk population (use only with codes for immunization)
SL State supplied vaccine
SM Second surgical opinion
SN Third surgical opinion
SQ Item ordered by home health
SS Home infusion services provided in the infusion suite of the iv therapy provider
ST Related to trauma or injury
SU Procedure performed in physician’s office (to denote use of facility and equipment)
SV Pharmaceuticals delivered to patient’s home but not utilized
SW Services provided by a certified diabetic educator
SY Persons who are in close contact with member of high-risk population (use only with codes for immunization)
T1 Left foot, second digit
T2 Left foot, third digit
T3 Left foot, fourth digit
T4 Left foot, fifth digit
T5 Right foot, great toe
T6 Right foot, second digit
T7 Right foot, third digit
T8 Right foot, fourth digit
T9 Right foot, fifth digit
TA Left foot, great toe
TB Drug or biological acquired with 340b drug pricing program discount, reported for informational purposes for select entities
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
TD Rn
TE Lpn/lvn
TF Intermediate level of care
TG Complex/high tech level of care
TH Obstetrical treatment/services, prenatal or postpartum
TJ Program group, child and/or adolescent
TK Extra patient or passenger, non-ambulance
TL Early intervention/individualized family service plan (ifsp)
TM Individualized education program (iep)
TN Rural/outside providers’ customary service area
TP Medical transport, unloaded vehicle
TQ Basic life support transport by a volunteer ambulance provider
TR School-based individualized education program (iep) services provided outside the public school district responsible for the student
TS Follow-up service
TT Individualized service provided to more than one patient in same setting
TU Special payment rate, overtime
TV Special payment rates, holidays/weekends
TW Back-up equipment
U1 Medicaid level of care 1, as defined by each state
U2 Medicaid level of care 2, as defined by each state
U3 Medicaid level of care 3, as defined by each state
U4 Medicaid level of care 4, as defined by each state
U5 Medicaid level of care 5, as defined by each state
U6 Medicaid level of care 6, as defined by each state
U7 Medicaid level of care 7, as defined by each state
U8 Medicaid level of care 8, as defined by each state
U9 Medicaid level of care 9, as defined by each state
UA Medicaid level of care 10, as defined by each state
UB Medicaid level of care 11, as defined by each state
UC Medicaid level of care 12, as defined by each state
UD Medicaid level of care 13, as defined by each state
UE Used durable medical equipment
UF Services provided in the morning
UG Services provided in the afternoon
UH Services provided in the evening
UJ Services provided at night
UK Services provided on behalf of the client to someone other than the client (collateral relationship)
UN Two patients served
UP Three patients served
UQ Four patients served
UR Five patients served
US Six or more patients served
V1 Demonstration modifier 1
V2 Demonstration modifier 2
V3 Demonstration modifier 3
V4 Demonstration modifier 4
V5 Vascular catheter (alone or with any other vascular access)
V6 Arteriovenous graft (or other vascular access not including a vascular catheter)
V7 Arteriovenous fistula only (in use with two needles)
VM Medicare diabetes prevention program (mdpp) virtual make-up session
VP Aphakic patient
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
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
X3 Episodic/broad servies: 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
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
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
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
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
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
