The 2019 HCPCS Level II code set includes an unusual nine new Modifiers that help medical coders and billers accurately report services recently adopted or changed by Medicare. Some are already effective; others are effective January 1, 2019.

Modifiers CO and CQ

Modifiers CO and CQ identify therapy services provided by an occupational therapy assistant (OTA) or physical therapy assistant (PTA).

As described by Renee Dustman in “Therapy Services Get a Workout in Medicare Final Rule“, these new modifiers are payment modifiers to be used when an OTA or PTA provide more than 10 percent of the service.  The Centers for Medicare & Medicaid Services (CMS) plans to more completely revamp therapy services in the 2020 Medicare Physician Fee Schedule (MPFS).

Modifier ER

Modifier ER is primarily a billing modifier to help identify items and services furnished by an off-campus, provider based emergency department.

Modifier G0

Modifier G0 (G zero) is effective beginning January 1, 2019 to identify telehealth services furnished for purposed of diagnosis, evaluation, or treatment of symptoms of an acute stroke.

It’s valid for all of the following:

• Telehealth distant site codes billed with Place of Service (POS) code 02
• Telehealth originating site facility fee billed with code Q3014
• Critical Access hospitals (revenue codes 096X, 097X, or 098X)

Modifiers QA, QB, and QR

These oxygen services modifiers were effective April 1 and join existing modifiers QE, QF, and QG.

Modifier QQ

Modifier VM

Part of the Medicare Diabetes Prevention Program (MDPP) expanded model, this modifier can be added to G9874-G9879 and G9882-G9891 to identify a virtual make up session.