What is the G modifier?
Asked by: Sigmund Farrell | Last update: September 23, 2025Score: 4.6/5 (52 votes)
What is the G modifier for telehealth?
Modifier G0 telehealth service provided for purposes of diagnosis, evaluation, or treatment of symptoms of an acute stroke. Modifier G0 is used to indicate a service provided outside of a geographic location (such as a telehealth appointment).
What is the GC modifier used for?
What is the GC modifier and when do I use it? Government payers (Medi-Cal and Medicare) require the GC modifier to be appended to E/M codes when a resident, under the direction of a teaching physician in an approved teaching program, is involved in the care of a patient.
What is the GP modifier for reimbursement?
Effect on Reimbursement:
The presence or absence of the GP modifier directly influences reimbursement for physical therapy services. When properly appended to CPT codes, the GP modifier signals to insurance payers that the services were provided by qualified physical therapy professionals.
What is the GV and GW modifier in medical billing?
The GV and GW modifiers are used for Medicare hospice patients. The GV modifier is used to report services related to a patient's hospice care, while the GW modifier is used to report services that are unrelated to the patient's hospice care.
What is a Modifier in Medical Coding? CPT and HCPCS Modifiers for Beginners
What is G-code in medical billing?
G-CODES FOR FUNCTIONAL REPORTING
There are 42 functional G-codes, 14 sets of three codes each. Six of the G-code sets generally describe PT and OT functional limitations, and eight sets of G-codes generally describe SLP functional limitations.
What are G-code modifiers?
G-code modifiers (e.g., CK) are associated with a specific range of impairment (e.g., at least 40% but less than 60% impaired, limited, or restricted). For example, when reporting current mobility, a patient may have 40% to 50% impairment (CK) and treatment aims to reduce that to under 20% impairment (CI).
Who can bill with a GP modifier?
Used in conjunction with CPT® (Current Procedural Terminology) codes, the modifier “GP” shows that the therapy services were specifically provided by a physical therapist. This helps ensure accurate billing and reimbursement for physical therapy services under Medicare and other insurance company plans.
What insurance companies require the GP modifier?
The use of the GP modifier is required now on all claims to United Health Care and their affiliates, VA claims, Medicare claims, Blue Cross Blue Shield of Michigan and now Anthem Blue Cross of California.
What is the GG modifier for medical billing?
HCPCS modifier GG is used to report performance and payment of a screening mammography and diagnostic mammography on the same patient on the same day. Medicare allows additional mammogram films to be performed without an additional order from the treating physician.
Why is GP modifier used?
The GP modifier indicates that a physical therapist's services have been provided. It's commonly used in inpatient and outpatient multidisciplinary settings. It's also used for functional limitation reporting (FLR), as physical therapists must report G-codes, severity modifiers, and therapy modifiers.
What are GC and GE modifiers?
GC vs. GE Modifier
Modifiers GC and GE are used to identify the involvement of a resident in the care of the patient. These modifiers should be used on Medicare and Medicaid patients whenever a resident is involved in the care provided.
Does modifier GC reduce payment?
GC modifier has no impact on payment unless it is discovered on appeal that the teaching physician failed to document and electronically sign their attestation note. If you have a teaching physician supervising a resident, the GC modifier must be appended to that service.
Do telehealth visits need a modifier?
However, telehealth services are reported using a different place of service and/or require a modifier. The specific POS and modifier vary by payer.
What is the difference between Go and GP modifier?
Specialty Specific Modifiers
Modifier GN – Services delivered under an outpatient speech therapy plan of care. Modifier GO – Services delivered under an outpatient occupational therapy plan of care. Modifier GP – Services delivered under an outpatient physical therapy plan of care.
What is the modifier 25 on G codes?
Modifier 25 indicates on the day of a procedure, the patient's condition required a significant, separately identifiable E/M service, above and beyond the usual pre- and post-operative care associated with the procedure or service performed. E/M service may occur on the same day as a procedure.
When to add GP modifier?
Every service performed by a physical therapist (PT), occupational therapist (OT), or speech-language pathologist (SLP) requires a therapy modifier (GP, GO, GN) for claim submission. So in this scenario, you would affix the GP modifier to the claim.
Can a chiropractor use GP modifier?
So if you render and bill for 1-2 regions of CMT (98940) and therapeutic exercise (97110), then the 97110 chiropractic CPT code will receive the GP modifier.
Do I need a modifier for 99214?
Does 99214 need a modifier? Modifiers can be used with 99214 if applicable. For example, you can add Modifier 25 to the E/M visit with 99214 if there was a “separately identifiable E/M on the same day of a procedure” (source: ACC). Or add modifier 22 if the procedure was extra complex.
Does CPT 97140 need a GP modifier?
Here are some common modifiers used with 97140 and when to apply them: Always Therapy Modifiers: GP: This modifier indicates that the services were provided by a physical therapist. It's required for Medicare claims and often used by other payers as well.
Is there a modifier for covering physician?
The Q6 modifier, often referred to as the locum tenens modifier, is a billing code used in medical reimbursement to indicate that a substitute physician provided services.
Does UnitedHealthcare require GP modifier?
Effective with dates of service on or after July 1, 2020, UnitedHealthcare aligns with CMS and requires HCPCS modifiers GN, GO or GP to be reported with the codes designated by CMS as always therapy services.
What is G-code used for?
G-code (also RS-274) is the most widely used computer numerical control (CNC) and 3D printing programming language. It is used mainly in computer-aided manufacturing to control automated machine tools, as well as for 3D-printer slicer applications. The G stands for geometry.
When should G codes be used?
G-codes are used to report a beneficiary's functional limitation being treated and note whether the report is on the beneficiary's current status, projected goal status, or discharge status.
Where are G codes used?
G-code is a type of programming language used in the areas of Computer Numerical Control (CNC) and 3D printing for instructing machine tool movement. It is written in Computer Aided Manufacturing (CAM) software to provide automation instructions to various machine functions and tools. G-code stands for geometric code.