Modifier FY (Computed Radiography X‑ray)
Defines Humana's Medicare Advantage claims payment treatment for X‑ray services reported with modifier FY (computed radiography), including required use of the modifier and reimbursement reductions to the technical component (TC). Applies to providers billing Humana Medicare Advantage products.
No material clinical or coverage changes in this revision.
Modifier FY Billing and Payment Rules
Modifier FY billing and payment rules
Billing and payment rules for X‑ray services furnished using computed radiography (CR):
ALL of the following
- Providers must append modifier FY to procedure codes for X‑ray services furnished using computed radiography (CR).
- The modifier requirement applies to TC‑only charges and to global charges for CR X‑ray services.
- Humana reduces reimbursement for the technical component (TC) of CR X‑ray services by 7% for dates of service beginning January 1, 2018 through December 31, 2022, and by 10% for dates of service beginning January 1, 2023 and subsequent years.
- The TC reimbursement reduction applies to TC‑only charges and to the TC portion of global charges.
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