| 33 | Modifier 33 was created by the American Medical Association in response to the Affordable Care Act to identify services provided for preventive intent. It is appended to CPT/HCPCS codes that could be… | - Use modifier -33 when a CPT/HCPCS service that can be billed as either preventive or diagnostic/treatment is provided with preventive intent and aligns with USPSTF A or B recommendations or other… |
| 8P | Modifier 8P—Performance Measure Reporting Modifier – Action Not Performed, Reason Not Otherwise Specified— is appended only to CPT Category II quality-reporting codes to indicate that the specified… | - Use modifier -8P only with CPT Category II codes when the quality-measure action was not performed for an eligible patient and there is no documented reason in the medical record for omitting the… |
| 93 | Modifier 93 denotes that a billed service was delivered synchronously via audio-only telecommunications (real-time telephone or other audio-only system). The AMA added modifier 93 in CPT Appendix A… | - When to use: Apply modifier -93 when a synchronous, real-time, two-way patient–provider encounter is conducted entirely via audio-only (telephone or other real-time interactive audio-only… |
| 95 | Modifier 95 indicates that a service was provided via synchronous, real‑time audio‑video telehealth rather than in‑person. Per CMS, AAPC and professional associations, append modifier 95 to claim… | - Use modifier 95 to indicate a service was furnished via synchronous, real‑time audiovisual telehealth (a live audio‑video conference between patient and provider) rather than in‑person.
- Pair… |
| 25 | CPT modifier 25 indicates that on the same day as another procedure or service, the same physician or other qualified health care professional provided a significant, separately identifiable… | - When to apply: Use modifier 25 only on an E/M code to indicate the same provider delivered a significant, separately identifiable E/M service on the same day as another procedure or service — i.e.,… |