Addendum lists CPT/dental codes with modifier field

Addendum B provides an enumerated listing of CPT, HCPCS, A-, C-, D- and dental procedure codes and indicates a modifier field for each entry (shown as "Modifier = ."). Providers must use this addendum as the billing code/modifier reference for Iowa Medicaid for CY2026.

• CPT and dental codes are listed with modifier notation across the addendum.
• Document updated for January 1, 2026.

CPT/T codes shown with modifier placeholder

The document lists CPT/T procedure codes followed by the notation "Modifier = ." — this serves as the billing reference showing a modifier field is applicable for each listed procedure code.

• Examples: 0561U, Modifier = .; 0562T, Modifier = .

Enumerated procedure codes with modifier field (informational)

This section enumerates numerous procedure codes each presented with an associated modifier notation ("Modifier = ."); no coverage criteria, prior authorization, or documentation requirements are included in these listing chunks — use the list for billing reference only.

• Examples: 20561, Modifier = .; 20600, Modifier = .; 20604, Modifier = .

CPT codes listed with modifier placeholder

CPT procedure codes throughout the addendum are presented each followed by "Modifier = .", indicating a modifier field is applicable though the specific modifier value is not specified in these excerpts.

• Examples: 27430, Modifier = .; 27435, Modifier = .; 27437, Modifier = .

Procedure codes shown with modifier assignment (partial)

Multiple procedure codes are listed with the assignment notation "Modifier = ." indicating providers must include the appropriate modifier when billing; the specific modifier values are not shown in these excerpts and must be applied as appropriate per code.

• Examples: 33510, Modifier = .; 33511, Modifier = .; 33512, Modifier = .

Apply listed modifier notation when billing

Long sequences of procedure codes are enumerated with the notation "Modifier = ." — providers are required to append the appropriate modifier for each code when submitting claims to Iowa Medicaid.

• Examples from list: 42600, Modifier = .; 4260F, Modifier = .; 42700, Modifier = .

Procedure code list with modifier placeholder (continued)

The addendum contains another enumerated list of procedure codes each followed by "Modifier = ."; treat this list as a billing code table where a modifier field applies to every listed procedure code.

• Examples: 5250F, Modifier = .; 52597, Modifier = .; 52601, Modifier = .

Procedure codes with modifier placeholder (partial)

Additional procedure codes are shown with "Modifier = ." next to each entry. The listing is informational for billing and does not specify coverage determinations in these chunks.

• Examples: 64868, Modifier = .; 64872, Modifier = .; 64874, Modifier = .

Laboratory/diagnostic codes shown with modifier field

The addendum lists laboratory and diagnostic CPT/HCPCS procedure codes and indicates a modifier field for each entry ("Modifier = .") to be used for Iowa Medicaid billing.

• Examples: 80076, Modifier = .; 80143, Modifier = .; 86800 listed in coding appendix.

Procedure codes with unspecified modifier noted

Various procedure codes are presented throughout the addendum with "Modifier = ." notation; providers must recognize the modifier field applies but specific modifier values are not provided in these excerpts.

• Examples: 86596, Modifier = .; 87205, Modifier = .; 93662, Modifier = .

CPT/HCPCS and A-code list with modifier placeholders

A large enumerated series of CPT/HCPCS and A-codes are listed with the notation "Modifier = ." next to each code entry — use the series as the billing reference for applicable codes; specific modifier values are not shown here.

• Examples: 93457, Modifier = .; 93644, Modifier = .; A0420, Modifier = .

A‑code and related code listings indicate modifier field

Sections enumerate A‑codes and many other procedure and dental codes with "Modifier = ." after each code (e.g., A4604–A4721 and beyond); providers must include the appropriate modifier when billing, per the code's requirements.

• Examples: A4604, Modifier = .; A4722, Modifier = .

Continued A‑code and procedure code modifier listing

The listing continues across A‑codes ranges (A7010–A7509, A7520–A8004, etc.), each with "Modifier = ." notation indicating a modifier field is recorded for these codes in the addendum.

• Examples: A7010, Modifier = .; A7049, Modifier = .; A8004, Modifier = .

Dental and HCPCS E‑codes include modifier field

Dental CDT codes and HCPCS E‑series codes are listed with the notation "Modifier = ." — providers must supply the applicable modifier when billing these dental and HCPCS services to Iowa Medicaid.

• Examples: D0423, Modifier = .; D1510, Modifier = .; E0100, Modifier = .

HCPCS/G-code entries show modifier placeholder

HCPCS E-, G- and other HCPCS code entries are presented with "Modifier = ." across the listing (e.g., E0743, G8755, G8918); the period denotes a placeholder for the modifier value to be supplied by the provider when billing.

• Examples: E0743, Modifier = .; G8755, Modifier = .; G8918, Modifier = .

Modifier notation: 'Modifier = .' indicates placeholder for modifier value

Throughout Addendum B the notation "Modifier = ." follows each listed code; this indicates a modifier field is applicable but the specific modifier value is not shown in these excerpts — providers must apply the correct modifier when submitting claims.

• The period (.) is used in the document as a placeholder for modifier values.
• See full Addendum B for any specific modifier assignments or exceptions not included in these chunks.