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ALL MEDICAL CODES IN CATEGORY Modifiers for HCPCS codes

2025 HCPCS code GO

Modifier GO is used to indicate that a service is part of an outpatient occupational therapy plan of care.

2025 HCPCS code J4

DMEPOS item subject to DMEPOS competitive bidding program that is furnished by a hospital upon discharge.

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 U2

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

2025 HCPCS code M-KB

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

2025 HCPCS code A5

Modifier A5 is appended to a HCPCS code to identify a surgical dressing used for dressing five wounds.

2025 HCPCS code M-A6

Surgical dressing applied to six wounds.

2025 HCPCS code J1

Competitive acquisition program no-pay submission for a prescription number.

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 X5

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

2025 HCPCS code M-SM

Modifier SM is appended to evaluation and management codes for claims by a consulting provider when another provider has requested a second opinion.

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 XU

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

2025 HCPCS code XP

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

2025 HCPCS code M-VM

Modifier used to indicate a virtual make-up session for a missed in-person Medicare Diabetes Prevention Program (MDPP) group core session.

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 F9

Right hand, fifth digit. This modifier is used to indicate that a procedure was performed on the fifth digit (little finger) of the right hand.

2025 HCPCS code GY

Modifier GY is appended to a code to indicate that a service or item is statutorily excluded from Medicare coverage or doesn't meet the definition of a Medicare benefit, or for non-Medicare insurers, is not a contract benefit.

2025 HCPCS code GN

Modifier GN is used to indicate that a service is part of an outpatient speech language pathology plan of care.

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 N1

Group 1 oxygen coverage criteria met. This modifier indicates that the provided oxygen therapy service aligns with the payer's Group 1 coverage standards.

2025 HCPCS code M-AH

Modifier for services provided by a clinical psychologist.

2025 HCPCS code M-HC

Modifier HC designates services provided to adult participants in a geriatric care program.

2025 HCPCS code CC

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

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 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 A7

Surgical dressing for seven wounds.

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 F1

Left hand, second digit. This modifier is used to identify a procedure performed on the second digit (index finger) of the left hand.

2025 HCPCS code M-EX

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

2025 HCPCS code GP

Modifier GP denotes services that are part of an outpatient physical therapy plan of care.

2025 HCPCS code GH

Modifier GH is used to indicate that a screening mammogram was converted to a diagnostic mammogram on the same day, during a single exam.

2025 HCPCS code ER

Modifier ER is appended to HCPCS codes to indicate that an item or outpatient hospital service was furnished by an off-campus, provider-based emergency department.

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 H9

Modifier H9 is used to indicate that a service or procedure was performed by court order.

2025 HCPCS code HS

Family/couple without client present. This modifier is appended to a behavioral health service code to indicate that the provider met with the family or partner of a client without the client being present.

2025 HCPCS code GJ

This modifier is used when a non-participating physician provides emergency or urgent services to a Medicare patient.

2025 HCPCS code GW

Indicates a service provided to a hospice patient unrelated to their terminal condition.

2025 HCPCS code M-NB

Nebulizer system, any type, FDA-cleared for use with a specific drug.

2025 HCPCS code KN

Replacement of facial prosthesis using previous master model.

2025 HCPCS code PO

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

2025 HCPCS Modifier code PL

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

2025 HCPCS code QN

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

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 KY

Modifier KY is appended to codes for a claim for competitive bid (CB) wheelchair accessories in the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program number five.

2025 HCPCS code QL

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

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