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 quality action was not completed for an eligible patient and no reason was documented in the medical record. Use is allowed only when the specific quality measure’s documentation lists 8P as an accepted reporting option. As a Category II modifier it functions as an exclusion modifier for performance measurement: it removes the patient from the denominator for scoring because the action was not performed and no specific exclusion (medical, patient, or system) was recorded. This modifier does not assign a payment value and is not used to determine reimbursement; Category II codes and modifiers are optional quality-data reporting tools separate from Category I billing codes and payment determinations.

When billing, append 8P only to Category II codes (for example, reporting 3060F-8P for an HbA1c test not done with no documented reason) as permitted by the measure. The use of 8P signals to payers and quality programs (such as CMS quality reporting initiatives) that the numerator action was not completed and no documented reason exists, but it does not change reimbursement for services billed under Category I codes. CMS guidance requires that only Category II modifiers be used with Category II codes to ensure accurate quality data capture and measure evaluation.