HCPCS Reporting Changes

Oct. 1, 2016

Hopefully everyone is aware of the HCPCS reporting changes set to kick in next week. The best place to review those changes is here: https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/Downloads/SE1611.pdf

We also wanted to clarify a few things regarding these changes.

  1. The CG modifier should be used even when the only service listed on the UB-04 claim is a preventive service.
  2.  HCPCS codes G0436 and G0437 will be discontinued effective for dates of service after 10/1/2016. The proper codes for tobacco cessation counseling are 99406 and 99407.
  3. For purposes of RHC billing, modifiers 25 and 59 are interchangeable. We have confirmed this with CMS.

Nathan Baugh
National Association of Rural Health Clinics

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