Modifier 27 indicates a separate, subsequent outpatient hospital E/M service provided to the same patient on the same date by a different provider in a hospital outpatient setting. It is a facility-side modifier (hospital outpatient departments or ambulatory service centers) and is not used on professional/provider claims. Use of modifier 27 on the second (and any subsequent) applicable outpatient E/M code (e.g., CPT 99201–99499, ophthalmology E/M 92002–92014, HCPCS G0175, G0402, G0380–G0384, G0463) notifies payers that the facility is seeking separate reimbursement for a distinct encounter on the same date.

When applied correctly, modifier 27 allows the facility to be reimbursed for more than one outpatient E/M encounter on the same date of service because the visits were separate and provided by different providers; without the modifier the facility would typically be reimbursed for only one E/M for that date. Documentation must support that the encounters were distinct (different times, complaints, treatments, or providers). This modifier is expressly restricted to facility billing—it is not appropriate on professional claims, and same‑provider repeated E/M billing on the professional side is generally not permitted.

Real‑world examples include a patient seen in the emergency department in the morning and returning later that evening for a separate ED visit (bill the first E/M normally and append -27 to the second facility E/M), or a patient seen in a hospital outpatient primary care clinic in the morning and then in a hospital‑based cardiology clinic the same day by a different provider (append -27 to the subsequent facility E/M). Payer policies can vary and some private payers may require additional documentation or appeals even when modifier 27 is used; consult current AMA/CPT and CMS guidance and payer rules for any updates or specific requirements.