State & FederalMedicare AdvantageMarch 1, 2023

Informational Update: Modifier Usage (Policy G-06006)

Beginning January 1, 2024, Empire became Anthem. This article, published under the former brand, now applies to Anthem.

The Modifier Usage policy is aligning with Medicare modifier requirements by adding the following to our Related Coding section:

  • Modifier CO — Outpatient occupational therapy assistant services
  • Modifier CQ — Outpatient physical therapy assistant services

Additionally, Modifier FB (Item provided without cost to provider, supplier or practitioner, or full credit received for replaced device (examples, but not limited to, covered under warranty, replaced due to defect, free samples) was expanded to facility providers.

For additional information, please review the Modifier Usage reimbursement policy at https://www.empireblue.com/medicareprovider.

httpswwwempirebluecommedicareprovider NYBCBS-CR-015033-22-CPN10025

PUBLICATIONS: March 2023 Empire Provider News