HCPCS Code Modifiers

HCPCS National Level II Modifiers

section notes

G Modifiers

section notes
G0   Telestroke
G1   Urr reading of less than 60
G2   Urr reading of 60 to 64.9
G3   Urr reading of 65 to 69.9
G4   Urr reading of 70 to 74.9
G5   Urr reading of 75 or greater
G6   Esrd patient <6 dialysis/mth
G7   Payment limits do not apply
G8   Monitored anesthesia care
G9   Mac for at risk patient
GA   Liability waiver ind case
GB   Claim resubmitted
GC   Resident/teaching phys serv
GE   Resident prim care exception
GF   Nonphysician serv c a hosp
GG   Payment screen mam + diagmam
GH   Diag mammo to screening mamo
GJ   Opt out provider of er srvc
GK   Actual item/service ordered
GL   Upgraded item, no charge
GM   Multiple transports
GN   Op speech language service
GO   Op occupational therapy serv
GP   Op pt services
GQ   Telehealth store and forward
GR   Service by va resident
GS   Epo/darbepoietin reduced 25%
GT   Interactivetelecommunication
GU   Liability waiver rout notice
GV   Attending phys not hospice
GW   Service unrelated to term co
GX   Voluntary liability notice
GY   Statutorily excluded
GZ   Not reasonable and necessary
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