Modifier SU (Procedure Performed in Physician's Office — Facility and Equipment)
Defines when Premera recognizes modifier SU on professional claims to indicate additional facility/equipment costs and states the Plan's reimbursement stance; applies to Premera Blue Cross and affiliated lines of business and products.
Clarified the policy statement to include examples of facility services and details to indicate modifier SU is not allowed with POS 11.
Minor clarifications to the Policy statement and added a paragraph specifying inclusion of office facility and equipment in practice expense RVUs.
Coverage Criteria for Modifier SU
Modifier SU coverage criteria
The Plan's coverage stance for services billed with modifier SU is as follows:
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