HCPCS Code Modifiers

HCPCS National Level II Modifiers

section notes

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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