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Hospitals may append modifier 27 to the second and subsequent outpatient hospital E/M code to indicate the E/M service is a “separate and distinct E/M encounter” from the service previously provided the same day in the same or different hos…
Read this article, which provides billing guidance for acute kidney injury.
Telehealth modifiers should be submitted with distant site telehealth services. Patient must be present and participating in telehealth visit. View guidance in this article on the use of modifiers for these services.
Effective July 1, 2026, new billing instructions apply related to no longer submitting the AX modifier and hemodiafiltration and AKI claims.
View details regarding specific modifiers including tips, decision flowcharts, and educational information.
Find the latest news pertaining to Medicare billing, coding, and general coverage changes.
Use this decision flowchart to assist in correctly applying the 25 modifier.
Use this decision flowchart to assist in correctly applying the 57 modifier.
Surgeons append modifier 66 to claims indicating they were on a team of surgeons performing a specific procedure on the same patient during the same operative session. Billing modifier 66 requires documentation to support the claim.
Use this decision flowchart to assist in correctly applying the 24 modifier.