What you need to know

Append modifier 27 when reporting multiple outpatient hospital evaluation and management (E/M) services on the same date.

• Modifier 27 was created exclusively for hospital outpatient departments (example: hospital emergency department, clinic, and critical care).
• Note: Physician practices may not use this modifier. This modifier should only be reported on the UB-04 Part A claim form or electronic equivalent.
• Hospitals may append modifier 27 to the second and subsequent E/M code to indicate that the E/M service is a “separate and distinct E/M encounter” from the service previously provided that same day in the same or different hospital setting.
• Hospitals may append modifier 27 to the range of E/M service codes listed below.
  • 92002-92014 (Ophthalmological E/M services)
  • 99281-99285 (Hospital type A emergency department visits)
  • 99291-99292 (Critical care)
  • G0175 (Interdisciplinary team conference)
  • G0380-G0384 (Hospital type B emergency department visits)
  • G0402 (Initial preventive physical examination)
  • G0463 (Hospital outpatient clinic visit for assessment and management)
• Report condition code G0 (zero) with modifier 27 when multiple medical visits occur on the same day in the same revenue centers. For additional information on condition code G0, please review Proper Reporting of Condition Code G0.