Mind your modifiers: Get to know the new Fab 4 – modifiers created to facilitate claims monitoring

Why This Topic Matters

The article matters because it highlights new claim-reporting tools CMS introduced to support utilization review and program integrity. Practices that bill Medicare or work with E/M and telehealth services need to know that the changes affect reporting workflows, staff training, and documentation awareness.

Article Sections

1. Introductory overview

   Sets up the 2022 timing of the new modifiers and explains that CMS issued them with limited initial guidance. It frames the article as a staff-training and awareness resource.

2. FQ

   Summarizes the first new modifier and the general circumstances CMS associated with it. The section describes the telehealth and audio-only context at a broad level.

3. FR

   Covers the second new modifier and the supervision-related policy background described by CMS. It discusses the role of virtual supervision and pending future guidance.

4. FS

   Reviews the split or shared visit modifier and its connection to facility-based evaluation and management services and critical care. It also notes CMS commentary about reporting and claims processing.

5. FT

   Explains the fourth modifier in the context of unrelated evaluation and management services during global surgical periods and same-day encounters. The section also references related CMS guidance and another established modifier.

6. New modifiers

   Provides a wrap-up on the purpose of the modifiers and the claims-monitoring and program-integrity rationale CMS gave for creating them. It emphasizes preparation through policy review and staff training.