Add Modifiers for CPT Codes

  Permissions: You must have Administration Permissions.

An Insurance Payer may require that you further define a CPT Code or Service Type by adding a Modifier. A Modifier is a 2-digit code attached to the Service Type. You will need to check with the Insurance Payer to see if a Modifier is needed.

NOTE: The American Medical Association owns the rights to all CPT® codes and is now enforcing the collection of licensing fees for each Rendering Provider who submits Claims utilizing these codes.

If you are submitting to multiple Payers, it is important to note that they may require different Modifiers. For example, BCBS may require a '95' Modifier for Telehealth, where as Atena may require 'GT'. In that case, you will need to enter that Service Type 'Telehealth' twice once with the 95 Modifier and once with the GT Modifier.

NOTE: You may want to include additional information in the Service Type Name in this situation so you can easily distinguish which Service Type to use for an Appointment.

Add a Modifier

Modifiers need to be attached to the Service Type or CPT Code. To do this, locate the desired Service Type and edit to add the Modifier.

1. Click Organization tab in primary navigation bar.
2. In Settings, click the Service Types tab.
3. Either add a New Service Type.
4. OR, click Edit for an existing Service Type.
5. Add Code Modifiers on left.
6. Click Save.