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US · guidance

CMS Pub. 100-04, ch. 4, § 20.6.1

Where to Report Modifiers on the Hospital Part B Claim

activein force · 2026-08-25 – presentas-observed

Modifiers are reported on the hardcopy Form CMS-1450 with the HCPCS code. See

Chapter 25 of this manual for related instructions. For electronic submissions, see

the ASC X12 837 Institutional Claim implementation guide for instructions related to

HCPCS modifiers when using the ASC X12 837 institutional claim format. Note there is

space for four modifiers on the hardcopy and electronic forms.

HOPDs are reminded that the most specific modifier should be used first. That is, when

modifiers E1 through E4, FA through F9, LC, LD, RC, and TA through T9 apply, they

should be used before modifiers LT, RT, or 59.

History

(Rev. 11937; Issued: 03-31-23; Effective: 04-01-23; Implementation: 04-03-23)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
c96e59beb1cc8c0ff803943e75990e64171c16cf6e756234f912fcda083a85aa
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