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HCPCS modifiers

A modifier is a two-character code appended to a procedure or supply code to show that the service was altered by a specific circumstance without changing what the code itself means. The CMS October 2026 file lists 364 active Level II modifiers. The most familiar family is the dressing and wound-care modifiers A1 to A9; others route claims correctly for ambulance origin and destination, anesthesia, and durable medical equipment rental or purchase.

ModifierLong descriptionShort description
A1Dressing for one woundDressing for one wound
A2Dressing for two woundsDressing for two wounds
A3Dressing for three woundsDressing for three wounds
A4Dressing for four woundsDressing for four wounds
A5Dressing for five woundsDressing for five wounds
A6Dressing for six woundsDressing for six wounds
A7Dressing for seven woundsDressing for seven wounds
A8Dressing for eight woundsDressing for eight wounds
A9Dressing for nine or more woundsDressing for 9 or more wound
AAAnesthesia services performed personally by anesthesiologistAnesthesia perf by anesgst
ABAudiology 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 beneficiaryAud svs w/o order evry 12mo
ACInitial onboarding support payment for access beneficiary enrollment, device/app setup, and care coordination activities; first month only; once per beneficiary per trackCo-mgmt mod - onboarding
ADMedical supervision by a physician: more than four concurrent anesthesia proceduresMd supervision, >4 anes proc
AERegistered dieticianRegistered dietician
AFSpecialty physicianSpecialty physician
AGPrimary physicianPrimary physician
AHClinical psychologistClinical psychologist
AIPrincipal physician of recordPrincipal physician of rec
AJClinical social workerClinical social worker
AKNon participating physicianNon participating physician
AMPhysician, team member servicePhysician, team member svc
AOAlternate payment method declined by provider of serviceProv declined alt pmt method
APDetermination of refractive state was not performed in the course of diagnostic ophthalmological examinationNo dtmn of refractive state
AQPhysician providing a service in an unlisted health professional shortage area (hpsa)Physician service hpsa area
ARPhysician provider services in a physician scarcity areaPhysician scarcity area
ASPhysician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgeryAssistant at surgery service
ATAcute treatment (this modifier should be used when reporting service 98940, 98941, 98942)Acute treatment
AUItem furnished in conjunction with a urological, ostomy, or tracheostomy supplyUro, ostomy or trach item
AVItem furnished in conjunction with a prosthetic device, prosthetic or orthoticItem w prosthetic/orthotic
AWItem furnished in conjunction with a surgical dressingItem w a surgical dressing
AXItem furnished in conjunction with dialysis servicesItem w dialysis services
AYItem or service furnished to an esrd patient that is not for the treatment of esrdItem/service not for esrd tx
AZPhysician providing a service in a dental health professional shortage area for the purpose of an electronic health record incentive paymentPhysician serv in dent hpsa
BAItem furnished in conjunction with parenteral enteral nutrition (pen) servicesItem w pen services
BLSpecial acquisition of blood and blood productsSpec acquisition blood prods
BOOrally administered nutrition, not by feeding tubeNutrition oral admin no tube
BPThe beneficiary has been informed of the purchase and rental options and has elected to purchase the itemBene electd to purchase item
BRThe beneficiary has been informed of the purchase and rental options and has elected to rent the itemBene elected to rent item
BUThe beneficiary has been informed of the purchase and rental options and after 30 days has not informed the supplier of his/her decisionBene undecided on purch/rent
CAProcedure payable only in the inpatient setting when performed emergently on an outpatient who expires prior to admissionProcedure payable inpatient
CBService 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 reimbursableEsrd bene part a snf-sep pay
CCProcedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)Procedure code change
CDAmcc test has been ordered by an esrd facility or mcp physician that is part of the composite rate and is not separately billableAmcc test for esrd or mcp md
CEAmcc 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 necessityMed neces amcc tst sep reimb
CFAmcc test has been ordered by an esrd facility or mcp physician that is not part of the composite rate and is separately billableAmcc tst not composite rate
CGPolicy criteria appliedPolicy criteria applied
CH0 percent impaired, limited or restricted0 percent impaired, ltd, res
CIAt least 1 percent but less than 20 percent impaired, limited or restricted1 to <20 percent impaired
CJAt least 20 percent but less than 40 percent impaired, limited or restricted20 to <40 percent impaired
CKAt least 40 percent but less than 60 percent impaired, limited or restricted40 to <60 percent impaired
CLAt least 60 percent but less than 80 percent impaired, limited or restricted60 to <80 percent impaired
CMAt least 80 percent but less than 100 percent impaired, limited or restricted80 to <100 percent impaired
CN100 percent impaired, limited or restricted100 percent impaired, ltd
COOutpatient occupational therapy services furnished in whole or in part by an occupational therapy assistantOutpatient ot service by ota
CQOutpatient physical therapy services furnished in whole or in part by a physical therapist assistantOutpatient pt service by pta
CRCatastrophe/disaster relatedCatastrophe/disaster related
CSCost-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 emergencyCost share waiver covid-19
CTComputed tomography services furnished using equipment that does not meet each of the attributes of the national electrical manufacturers association (nema) xr-29-2013 standardCt does not meet nema standa
DAOral health assessment by a licensed health professional other than a dentistOral health assess, not dent
E1Upper left, eyelidUpper left eyelid
E2Lower left, eyelidLower left eyelid
E3Upper right, eyelidUpper right eyelid
E4Lower right, eyelidLower right eyelid
EAErythropoietic stimulating agent (esa) administered to treat anemia due to anti-cancer chemotherapyEsa, anemia, chemo-induced
EBErythropoietic stimulating agent (esa) administered to treat anemia due to anti-cancer radiotherapyEsa, anemia, radio-induced
ECErythropoietic stimulating agent (esa) administered to treat anemia not due to anti-cancer radiotherapy or anti-cancer chemotherapyEsa, anemia, non-chemo/radio
EDHematocrit 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 cycleHct>39% or hgb>13g>=3 cycle
EEHematocrit 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 cycleHct>39% or hgb>13g<3 cycle
EJSubsequent claims for a defined course of therapy, e.g., epo, sodium hyaluronate, infliximabSubsequent claim
EMEmergency reserve supply (for esrd benefit only)Emer reserve supply (esrd)
EPService provided as part of medicaid early periodic screening diagnosis and treatment (epsdt) programMedicaid epsdt program svc
ERItems and services furnished by a provider-based, off-campus emergency departmentOff-campus ed service
ETEmergency servicesEmergency services
EXExpatriate beneficiaryExpatriate beneficiary
EYNo physician or other licensed health care provider order for this item or serviceNo md order for item/service
F1Left hand, second digitLeft hand, second digit
F2Left hand, third digitLeft hand, third digit
F3Left hand, fourth digitLeft hand, fourth digit
F4Left hand, fifth digitLeft hand, fifth digit
F5Right hand, thumbRight hand, thumb
F6Right hand, second digitRight hand, second digit
F7Right hand, third digitRight hand, third digit
F8Right hand, fourth digitRight hand, fourth digit
F9Right hand, fifth digitRight hand, fifth digit
FALeft hand, thumbLeft hand, thumb
FBItem 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)Item provided without cost
FCPartial credit received for replaced devicePart credit, replaced device
FPService provided as part of family planning programSvc part of family plan pgm
FQThe service was furnished using audio-only communication technologyAudio-only service
FRThe supervising practitioner was present through two-way, audio/video communication technologyTwo-way a/v dir supervision
FSSplit (or shared) evaluation and management visitSplit or shared e/m visit
FTUnrelated 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)Separate, unrelated e/m
FXX-ray taken using filmX-ray taken using film
FYX-ray taken using computed radiography technology/cassette-based imagingComputed radiography x-ray
G0Telehealth services for diagnosis, evaluation, or treatment, of symptoms of an acute strokeTelestroke
G1Most recent urr reading of less than 60Urr reading of less than 60
G2Most recent urr reading of 60 to 64.9Urr reading of 60 to 64.9
G3Most recent urr reading of 65 to 69.9Urr reading of 65 to 69.9
G4Most recent urr reading of 70 to 74.9Urr reading of 70 to 74.9
G5Most recent urr reading of 75 or greaterUrr reading of 75 or greater
G6Esrd patient for whom less than six dialysis sessions have been provided in a monthEsrd patient <6 dialysis/mth
G7Pregnancy resulted from rape or incest or pregnancy certified by physician as life threateningPayment limits do not apply
G8Monitored anesthesia care (mac) for deep complex, complicated, or markedly invasive surgical procedureMonitored anesthesia care
G9Monitored anesthesia care for patient who has history of severe cardio-pulmonary conditionMac for at risk patient
GAWaiver of liability statement issued as required by payer policy, individual caseLiability waiver ind case
GBClaim being re-submitted for payment because it is no longer covered under a global payment demonstrationClaim resubmitted
GCThis service has been performed in part by a resident under the direction of a teaching physicianResident/teaching phys serv
GEThis service has been performed by a resident without the presence of a teaching physician under the primary care exceptionResident prim care exception
GFNon-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 hospitalNonphysician serv c a hosp
GGPerformance and payment of a screening mammogram and diagnostic mammogram on the same patient, same dayPayment screen mam + diagmam
GHDiagnostic mammogram converted from screening mammogram on same dayDiag mammo to screening mamo
GJ"opt out" physician or practitioner emergency or urgent serviceOpt out provider of er srvc
GKReasonable and necessary item/service associated with a ga or gz modifierActual item/service ordered
GLMedically unnecessary upgrade provided instead of non-upgraded item, no charge, no advance beneficiary notice (abn)Upgraded item, no charge
GMMultiple patients on one ambulance tripMultiple transports
GNServices delivered under an outpatient speech language pathology plan of careOp speech language service
GOServices delivered under an outpatient occupational therapy plan of careOp occupational therapy serv
GPServices delivered under an outpatient physical therapy plan of careOp pt services
GQVia asynchronous telecommunications systemTelehealth store and forward
GRThis 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 policyService by va resident
GSDosage of erythropoietin stimulating agent has been reduced and maintained in response to hematocrit or hemoglobin levelEpo/darbepoietin reduced 25%
GTVia interactive audio and video telecommunication systemsInteractivetelecommunication
GUWaiver of liability statement issued as required by payer policy, routine noticeLiability waiver rout notice
GVAttending physician not employed or paid under arrangement by the patient's hospice providerAttending phys not hospice
GWService not related to the hospice patient's terminal conditionService unrelated to term co
GXNotice of liability issued, voluntary under payer policyVoluntary liability notice
GYItem or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefitStatutorily excluded
GZItem or service expected to be denied as not reasonable and necessaryNot reasonable and necessary
H9Court-orderedCourt-ordered
HAChild/adolescent programChild/adolescent program
HBAdult program, non geriatricAdult program non-geriatric
HCAdult program, geriatricAdult program geriatric
HDPregnant/parenting women's programPregnant/parenting program
HEMental health programMental health program
HFSubstance abuse programSubstance abuse program
HGOpioid addiction treatment programOpioid addiction tx program
HHIntegrated mental health/substance abuse programMental hlth/substance abs pr
HIIntegrated mental health and intellectual disability/developmental disabilities programMen hlth intel/dev disab pgm
HJEmployee assistance programEmployee assistance program
HKSpecialized mental health programs for high-risk populationsSpec hgh rsk mntl hlth pop p
HLInternIntern
HMLess than bachelor degree levelLess than bachelor degree lv
HNBachelors degree levelBachelors degree level
HOMasters degree levelMasters degree level
HPDoctoral levelDoctoral level
HQGroup settingGroup setting
HRFamily/couple with client presentFamily/couple w client prsnt
HSFamily/couple without client presentFamily/couple w/o client prs
HTMulti-disciplinary teamMulti-disciplinary team
HUFunded by child welfare agencyChild welfare agency funded
HVFunded state addictions agencyFunded state addiction agncy
HWFunded by state mental health agencyState mntl hlth agncy funded
HXFunded by county/local agencyCounty/local agency funded
HYFunded by juvenile justice agencyFunded by juvenile justice
HZFunded by criminal justice agencyCriminal justice agncy fund
J1Competitive acquisition program no-pay submission for a prescription numberCap no-pay for prescript num
J2Competitive acquisition program, restocking of emergency drugs after emergency administrationCap restock of emerg drugs
J3Competitive acquisition program (cap), drug not available through cap as written, reimbursed under average sales price methodologyCap drug unavail thru cap
J4Dmepos item subject to dmepos competitive bidding program that is furnished by a hospital upon dischargeDmepos comp bid furn by hosp
J5Off-the-shelf orthotic subject to dmepos competitive bidding program that is furnished as part of a physical therapist or occupational therapist professional serviceDmepos comp bid fur by pt/ot
JAAdministered intravenouslyAdministered intravenously
JBAdministered subcutaneouslyAdministered subcutaneously
JCSkin substitute used as a graftSkin substitute graft
JDSkin substitute not used as a graftSkin sub not used as a graft
JEAdministered via dialysateAdministered via dialysate
JKOne month supply or less of drug or biologicalDrug supply 1 month or less
JLThree month supply of drug or biologicalDrug 3 month supply
JWDrug amount discarded/not administered to any patientDiscarded drug not administe
JZZero drug amount discarded/not administered to any patientZero drug wasted
K0Lower 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.Lwr ext prost functnl lvl 0
K1Lower 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.Lwr ext prost functnl lvl 1
K2Lower 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.Lwr ext prost functnl lvl 2
K3Lower 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.Lwr ext prost functnl lvl 3
K4Lower 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.Lwr ext prost functnl lvl 4
KAAdd on option/accessory for wheelchairWheelchair add-on option/acc
KBBeneficiary requested upgrade for abn, more than 4 modifiers identified on claim>4 modifiers on claim
KCReplacement of special power wheelchair interfaceRepl special pwr wc intrface
KDDrug or biological infused through dmeDrug/biological dme infused
KEBid under round one of the dmepos competitive bidding program for use with non-competitive bid base equipmentBid under round 1 dmepos cb
KFItem designated by fda as class iii deviceFda class iii device
KGDmepos item subject to dmepos competitive bidding program number 1Dmepos comp bid prgm no 1
KHDmepos item, initial claim, purchase or first month rentalDmepos ini clm, pur/1 mo rnt
KIDmepos item, second or third month rentalDmepos 2nd or 3rd mo rental
KJDmepos item, parenteral enteral nutrition (pen) pump or capped rental, months four to fifteenDmepos pen pmp or 4-15mo rnt
KKDmepos item subject to dmepos competitive bidding program number 2Dmepos comp bid prgm no 2
KLDmepos item delivered via mailDmepos mailorder comp bid
KMReplacement of facial prosthesis including new impression/moulageRplc facial prosth new imp
KNReplacement of facial prosthesis using previous master modelRplc facial prosth old mod
KOSingle drug unit dose formulationSingle drug unit dose form
KPFirst drug of a multiple drug unit dose formulationFirst drug of multi drug u d
KQSecond or subsequent drug of a multiple drug unit dose formulation2nd/subsqnt drg multi drg ud
KRRental item, billing for partial monthRental item partial month
KSGlucose monitor supply for diabetic beneficiary not treated with insulinGlucose monitor supply
KTBeneficiary resides in a competitive bidding area and travels outside that competitive bidding area and receives a competitive bid itemItem from noncontract supply
KUDmepos item subject to dmepos competitive bidding program number 3Dmepos comp bid prgm no 3
KVDmepos item subject to dmepos competitive bidding program that is furnished as part of a professional serviceDmepos item, profession serv
KWDmepos item subject to dmepos competitive bidding program number 4Dmepos comp bid prgm no 4
KXRequirements specified in the medical policy have been metDocumentation on file
KYDmepos item subject to dmepos competitive bidding program number 5Dmepos comp bid prgm no 5
KZNew coverage not implemented by managed careNew cov not implement by m+c
LCLeft circumflex coronary arteryLft circum coronary artery
LDLeft anterior descending coronary arteryLeft ant des coronary artery
LLLease/rental (use the 'll' modifier when dme equipment rental is to be applied against the purchase price)Lease/rental (appld to pur)
LMLeft main coronary arteryLeft main coronary artery
LRLaboratory round tripLaboratory round trip
LSFda-monitored intraocular lens implantFda-monitored iol implant
LTLeft side (used to identify procedures performed on the left side of the body)Left side
LUFractionated paymentFractionated payment
M2Medicare secondary payer (msp)Medicare secondary payer
MSSix month maintenance and servicing fee for reasonable and necessary parts and labor which are not covered under any manufacturer or supplier warranty6-mo maint/svc fee parts/lbr
N1Group 1 oxygen coverage criteria metGroup 1 oxygen cov crit met
N2Group 2 oxygen coverage criteria metGroup 2 oxygen cov crit met
N3Group 3 oxygen coverage criteria metGroup 3 oxygen cov crit met
NBNebulizer system, any type, fda-cleared for use with specific drugDrug specific nebulizer
NRNew when rented (use the 'nr' modifier when dme which was new at the time of rental is subsequently purchased)New when rented
NUNew equipmentNew equipment
P1A normal healthy patientNormal healthy patient
P2A patient with mild systemic diseasePatient w/mild syst disease
P3A patient with severe systemic diseasePatient w/severe sys disease
P4A patient with severe systemic disease that is a constant threat to lifePt w/sev sys dis threat life
P5A moribund patient who is not expected to survive without the operationPt not expect surv w/o oper
P6A declared brain-dead patient whose organs are being removed for donor purposesBrain-dead pt organs removed
PASurgical or other invasive procedure on wrong body partSurgery, wrong body part
PBSurgical or other invasive procedure on wrong patientSurgery, wrong patient
PCWrong surgery or other invasive procedure on patientWrong surgery on patient
PDDiagnostic 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 daysInp admit w/in 3 days
PIPositron 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 testingPet tumor init tx strat
PLProgressive addition lensesProgressive addition lenses
PMPost mortemPost mortem
PNNon-excepted service provided at an off-campus, outpatient, provider-based department of a hospitalNon-excepted off-campus svc
POExcepted service provided at an off-campus, outpatient, provider-based department of a hospitalExcepted off-campus service
PSPositron 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 strategyPet tumor subsq tx strategy
PTColorectal cancer screening test; converted to diagnostic test or other procedureClrctal screen to diagn
Q0Investigational clinical service provided in a clinical research study that is in an approved clinical research studyInvest clinical research
Q1Routine clinical service provided in a clinical research study that is in an approved clinical research studyRoutine clinical research
Q2Demonstration procedure/serviceDemo procedure, service
Q3Live kidney donor surgery and related servicesLive donor surgery/services
Q4Service for ordering/referring physician qualifies as a service exemptionSvc exempt - ordrg/rfrng md
Q5Service 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 areaRecip bill arr subs md or pt
Q6Service 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 areaFee/time comp subst md or pt
Q7One class a findingOne class a finding
Q8Two class b findingsTwo class b findings
Q9One class b and two class c findings1 class b & 2 class c fndngs
QAPrescribed 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)Avg sta day/night o2 < 1 lpm
QBPrescribed 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 prescribedAvg day/nite o2 > 4 lpm/port
QCSingle channel monitoringSingle channel monitoring
QDRecording and storage in solid state memory by a digital recorderRcrdg/strg in sld st memory
QEPrescribed amount of stationary oxygen while at rest is less than 1 liter per minute (lpm)Stationary o2 @ rest <1 lpm
QFPrescribed amount of stationary oxygen while at rest exceeds 4 liters per minute (lpm) and portable oxygen is prescribedStation o2 @ rest >4lpm/port
QGPrescribed amount of stationary oxygen while at rest is greater than 4 liters per minute (lpm)Station o2 @ rest > 4 lpm
QHOxygen conserving device is being used with an oxygen delivery systemOxygen cnsrvg dvc w del sys
QJServices/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)Patient in state/locl custod
QKMedical direction of two, three, or four concurrent anesthesia procedures involving qualified individualsMed dir 2-4 cncrnt anes proc
QLPatient pronounced dead after ambulance calledPatient died after amb call
QMAmbulance service provided under arrangement by a provider of servicesAmbulance arr by provider
QNAmbulance service furnished directly by a provider of servicesAmbulance furn by provider
QPDocumentation 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.Individually ordered lab tst
QRPrescribed 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)Avg sta day/night o2 > 4 lpm
QSMonitored anesthesia care serviceMonitored anesthesia care
QTRecording and storage on tape by an analog tape recorderRcrdg/strg tape analog recdr
QWClia waived testClia waived test
QXCrna service: with medical direction by a physicianCrna svc w/ md med direction
QYMedical direction of one certified registered nurse anesthetist (crna) by an anesthesiologistMedically directed crna
QZCrna service: without medical direction by a physicianCrna svc w/o med dir by md
RAReplacement of a dme, orthotic or prosthetic itemReplacement of dme item
RBReplacement of a part of a dme, orthotic or prosthetic item furnished as part of a repairReplacement part, dme item
RCRight coronary arteryRight coronary artery
RDDrug provided to beneficiary, but not administered "incident-to"Drug admin not incident-to
REFurnished in full compliance with fda-mandated risk evaluation and mitigation strategy (rems)Furnish full compliance rems
RIRamus intermedius coronary arteryRamus intermedius cor artery
RRRental (use the 'rr' modifier when dme is to be rented)Rental (dme)
RTRight side (used to identify procedures performed on the right side of the body)Right side
SANurse practitioner rendering service in collaboration with a physicianNurse practitioner w physici
SBNurse midwifeNurse midwife
SCMedically necessary service or supplyMedically necessary serv/sup
SDServices provided by registered nurse with specialized, highly technical home infusion trainingServ by home infusion rn
SEState and/or federally-funded programs/servicesState/fed funded program/ser
SFSecond opinion ordered by a professional review organization (pro) per section 9401, p.l. 99-272 (100% reimbursement - no medicare deductible or coinsurance)2nd opinion ordered by pro
SGAmbulatory surgical center (asc) facility serviceAsc facility service
SHSecond concurrently administered infusion therapy2nd concurrent infusion ther
SJThird or more concurrently administered infusion therapy3rd concurrent infusion ther
SKMember of high risk population (use only with codes for immunization)High risk population
SLState supplied vaccineState supplied vaccine
SMSecond surgical opinionSecond opinion
SNThird surgical opinionThird opinion
SQItem ordered by home healthItem ordered by home health
SSHome infusion services provided in the infusion suite of the iv therapy providerHit in infusion suite
STRelated to trauma or injuryRelated to trauma or injury
SUProcedure performed in physician's office (to denote use of facility and equipment)Performed in phys office
SVPharmaceuticals delivered to patient's home but not utilizedDrugs delivered not used
SWServices provided by a certified diabetic educatorServ by cert diab educator
SYPersons who are in close contact with member of high-risk population (use only with codes for immunization)Contact w/high-risk pop
T1Left foot, second digitLeft foot, second digit
T2Left foot, third digitLeft foot, third digit
T3Left foot, fourth digitLeft foot, fourth digit
T4Left foot, fifth digitLeft foot, fifth digit
T5Right foot, great toeRight foot, great toe
T6Right foot, second digitRight foot, second digit
T7Right foot, third digitRight foot, third digit
T8Right foot, fourth digitRight foot, fourth digit
T9Right foot, fifth digitRight foot, fifth digit
TALeft foot, great toeLeft foot, great toe
TBDrug or biological acquired with 340b drug pricing program discount, reported for informational purposes340b drug
TCTechnical 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 profilesTechnical component
TDRnRn
TELpn/lvnLpn/lvn
TFIntermediate level of careIntermediate level of care
TGComplex/high tech level of careComplex/high tech level care
THObstetrical treatment/services, prenatal or postpartumOb tx/srvcs prenatl/postpart
TJProgram group, child and/or adolescentChild/adolescent program gp
TKExtra patient or passenger, non-ambulanceExtra patient or passenger
TLEarly intervention/individualized family service plan (ifsp)Early intervention ifsp
TMIndividualized education program (iep)Individualized ed prgrm(iep)
TNRural/outside providers' customary service areaRural/out of service area
TPMedical transport, unloaded vehicleMed transprt unloaded vehicl
TQBasic life support transport by a volunteer ambulance providerBls by volunteer amb providr
TRSchool-based individualized education program (iep) services provided outside the public school district responsible for the studentSchool-based iep out of dist
TSFollow-up serviceFollow-up service
TTIndividualized service provided to more than one patient in same settingAdditional patient
TUSpecial payment rate, overtimeOvertime payment rate
TVSpecial payment rates, holidays/weekendsHoliday/weekend payment rate
TWBack-up equipmentBack-up equipment
U1Medicaid level of care 1, as defined by each stateM/caid care lev 1 state def
U2Medicaid level of care 2, as defined by each stateM/caid care lev 2 state def
U3Medicaid level of care 3, as defined by each stateM/caid care lev 3 state def
U4Medicaid level of care 4, as defined by each stateM/caid care lev 4 state def
U5Medicaid level of care 5, as defined by each stateM/caid care lev 5 state def
U6Medicaid level of care 6, as defined by each stateM/caid care lev 6 state def
U7Medicaid level of care 7, as defined by each stateM/caid care lev 7 state def
U8Medicaid level of care 8, as defined by each stateM/caid care lev 8 state def
U9Medicaid level of care 9, as defined by each stateM/caid care lev 9 state def
UAMedicaid level of care 10, as defined by each stateM/caid care lev 10 state def
UBMedicaid level of care 11, as defined by each stateM/caid care lev 11 state def
UCMedicaid level of care 12, as defined by each stateM/caid care lev 12 state def
UDMedicaid level of care 13, as defined by each stateM/caid care lev 13 state def
UEUsed durable medical equipmentUsed durable med equipment
UFServices provided in the morningServices provided, morning
UGServices provided in the afternoonServices provided, afternoon
UHServices provided in the eveningServices provided, evening
UJServices provided at nightServices provided, night
UKServices provided on behalf of the client to someone other than the client (collateral relationship)Svc on behalf client-collat
UNTwo patients servedTwo patients served
UPThree patients servedThree patients served
UQFour patients servedFour patients served
URFive patients servedFive patients served
USSix or more patients servedSix or more patients served
V1Demonstration modifier 1Demonstration modifier 1
V2Demonstration modifier 2Demonstration modifier 2
V3Demonstration modifier 3Demonstration modifier 3
V4Demonstration modifier 4Demonstration modifier 4
V5Vascular catheter (alone or with any other vascular access)Vascular catheter
V6Arteriovenous graft (or other vascular access not including a vascular catheter)Arteriovenous graft
V7Arteriovenous fistula only (in use with two needles)Arteriovenous fistula
VMMedicare diabetes prevention program (mdpp) virtual make-up sessionMdpp virtual make-up session
VPAphakic patientAphakic patient
X1Continuous/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 careContinuous/broad services
X2Continuous/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 servicesContinuous/focused services
X3Episodic/broad services: 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 hospitalEpisodic/broad services
X4Episodic/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 periodEpisodic/focused services
X5Diagnostic 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 clinicianSvc req by another clinician
XESeparate encounter, a service that is distinct because it occurred during a separate encounterSeparate encounter
XPSeparate practitioner, a service that is distinct because it was performed by a different practitionerSeparate practitioner
XSSeparate structure, a service that is distinct because it was performed on a separate organ/structureSeparate organ/structure
XUUnusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main serviceUnusual separate service
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