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ALL MEDICAL CODES IN CATEGORY Modifiers for HCPCS codes

2025 HCPCS code M-KB

Modifier indicating beneficiary requested upgrade with ABN and more than four modifiers on the claim.

2025 HCPCS code XU

Indicates a service distinct due to non-overlap with usual components of the main service.

2025 HCPCS code CC

Indicates a procedure code change for administrative reasons or due to incorrect code usage.

2025 HCPCS code X5

Modifier X5 indicates that a primarily diagnostic service was rendered by a provider only at the request of another clinician.

2025 HCPCS code G0

Modifier G0 is appended to codes for the diagnosis, evaluation, or treatment of an acute stroke via an audio or video telecommunications system.

2025 HCPCS Modifier code MS

Six month maintenance and servicing fee for reasonable and necessary parts and labor which are not covered under any manufacturer or supplier warranty.

2025 HCPCS code M-A6

Surgical dressing applied to six wounds.

2025 HCPCS code 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.

2025 HCPCS code M-UD

Modifier UD is used to report services related to a Medicaid level of care 13, as defined by each state.

2025 HCPCS code T5

Modifier T5 is used to identify a procedure performed on the great toe of the right foot.

2025 HCPCS code U5

Modifier U5 is used with specific HCPCS codes to indicate a Medicaid level of care 5, as defined by each state.

2025 HCPCS code U6

Medicaid level of care 6, as defined by each state.

2025 HCPCS code T9

Right foot, fifth digit. This modifier identifies services performed on the fifth digit (toe) of a patient's right foot.

2025 HCPCS code U2

Medicaid level of care 2, as defined by each state.

2025 HCPCS code T4

Left foot, fifth digit.

2025 HCPCS code RA

Modifier RA is used when a supplier provides a new DMEPOS item to replace one that has been lost, stolen, or irreparably damaged.

2025 HCPCS code RB

Modifier used to indicate the replacement of a part of a DMEPOS item as part of a repair.

2025 HCPCS code QR

This modifier is used when a patient requires varying amounts of stationary oxygen during the day and night, and the average of these amounts exceeds 4 liters per minute (LPM).

2025 HCPCS code QW

Modifier QW is appended to a laboratory test which has been waived from Clinical Laboratory Improvement Amendments (CLIA) requirements.

2025 HCPCS code QM

Ambulance service provided under arrangement by a provider of services. This modifier is used when the provider has an agreement with an ambulance company for ambulance services.

2025 HCPCS code QN

Modifier used to indicate that ambulance services were furnished directly by a provider of services.

2025 HCPCS code QQ

Modifier QQ is appended to a code for services when the provider consulted and received qualified decision support in determining appropriate use criteria (AUC) before ordering an advanced imaging procedure.

2025 HCPCS Modifier code PL

Progressive addition lenses. This modifier indicates that the service or procedure performed involves progressive additional lenses.

2025 HCPCS code PM

Modifier PM is used to identify visits that occur after the death of a patient and on the same day as the patient’s death.

2025 HCPCS code PS

Modifier PS is used with PET or PET/CT scans to indicate that the study is being performed to determine the subsequent treatment strategy for cancerous tumors when the treating physician deems it necessary to inform the anti-tumor strategy.

2025 HCPCS code F5

Right hand, thumb.

2025 HCPCS code T2

Left foot, third digit.

2025 HCPCS code HQ

This modifier is appended to a behavioral health service code to indicate that the provider rendered the services in a group setting.

2025 HCPCS code 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.

2025 HCPCS code GM

This modifier is used to indicate multiple patients transported on one ambulance trip.

2025 HCPCS code HX

Indicates that the provider receives funds from a county or local agency to provide therapy to a patient.

2025 HCPCS code PO

Excepted service provided at an off-campus, outpatient, provider-based department of a hospital.

2025 HCPCS code NR

Modifier NR is used to indicate that a Durable Medical Equipment (DME) item, initially rented and new at the time of rental, has been subsequently purchased by the patient.

2025 HCPCS code PB

Surgical or other invasive procedure on the wrong patient.

2025 HCPCS code QL

Modifier QL is used to indicate that a patient was pronounced dead after an ambulance was called, but before transport.

2025 HCPCS code PN

Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital.

2025 HCPCS code QP

Modifier QP indicates 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.

2025 HCPCS code SL

State supplied vaccine

2025 HCPCS code T6

Right foot, second digit.

2025 HCPCS code T3

Left foot, fourth digit.

2025 HCPCS code SW

Services provided by a certified diabetic educator to a diabetic patient.

2025 HCPCS code TS

Follow-up service subsequent to the initial service or procedure.

2025 HCPCS code XS

Separate structure, a service that is distinct because it was performed on a separate organ/structure.

2025 HCPCS code TR

School-based individualized education program (IEP) services provided outside the public school district responsible for the student.

2025 HCPCS code UB

Modifier UB is used to report services related to a Medicaid level of care 11, as defined by each state. This level of care often relates to the amount of assistance a patient requires or the complexity of care.

2025 HCPCS code XP

Separate practitioner, a service that is distinct because it was performed by a different practitioner.

2025 HCPCS code UA

Modifier UA is used to report services related to a Medicaid level of care 10, as defined by each state. This level of care may relate to the amount of assistance a patient requires, or the complexity of care.

2025 HCPCS code M-EX

This modifier designates a non-U.S. citizen working in their home country.

2025 HCPCS code M-AF

Modifier used to indicate services provided by a specialty physician in a physician scarcity area.

2025 HCPCS code M-DA

Identifies an oral health assessment performed by a licensed health professional other than a dentist, for a patient with dental or oral health problems.