Modifiers for Medicare Billing
For Medicare purposes, modifiers are two-digit codes appended to procedure codes, to provideadditional information about the billed procedure. In some cases, addition of a modifier may directlyaffect payment. Below is a list of modifiers including the modifier description.
AMBULANCE CLAIM MODIFIERS
Modifiers that are used on claims for ambulance services are created by combining two alpha characters.Each alpha character, with the exception of X, represents an origin (source) code or a destination code.The pair of alpha codes creates one modifier. The first position alpha code = origin; the second positionalpha code = destination.Origin and destination codes and their descriptions are listed below:D Diagnostic or therapeutic site other than "P" or "H" when these are used as origin codesE Residential, domiciliary, custodial facility, nursing homeG Hospital based dialysis facility (hospital or hospital related)H HospitalI Site of transfer (e.g., airport or helicopter pad) between modes of ambulance transportJ Non-hospital based dialysis facility N Skilled nursing facility (SNF) (Medicare certified beds)P Physician’s office (includes HMO non-hospital facility, clinic, etc.)R ResidenceS Scene of accident or acute eventX (Destination code only) Intermediate stop at physician’s office en route to the hospital (includesHMO non-hospital facility, clinic, etc.)QL Patient Pronounced dead after ambulance calledThe following modifiers are valid for Medicare; however, the services would be denied under MedicarePart B as a Part A expense.QMAmbulance service provided under arrangement by hospitalQNAmbulance service furnished directly by hospital1