State & FederalMedicare AdvantageJanuary 31, 2020

Modifier 62 policy update: Co-Surgeons

Category: Medicare

Effective May 1, 2020, Anthem will update the Modifier 62: Co‑Surgeons reimbursement policy to expand the current policy’s language, adding that we do not consider surgeons performing different procedures during the same surgical session as co-surgeons, and Modifier 62 is not required.

 

Assistant surgeon and/or multiple procedures rules and fee reductions apply if a co-surgeon acts as an assistant in performing additional procedure(s) during the same surgical session.

 

Please note that assistant surgeon rules do not apply to procedures appropriately billed with Modifier 62.

 

Please visit www.anthem.com/medicareprovider to view the Modifier 62: Co-Surgeons reimbursement policy for additional information regarding percentages and reimbursement criteria.

 

ABSCRNU-0078-19