California Medical Association: Using Modifier 22 Correctly

“When applied properly, modifier 22 “unusual procedural service,” allows a provider to recover reimbursement above and beyond the regular payment for a difficult or time-consuming procedure,” wrote G. John Verhovshek, MA, CPC AAPC’s Director of Editorial Development, in the most recent California Medical Associations’ CMA Practice Resources.

He continued, “Only those surgeries “for which services performed are significantly greater than usually required” justify the use of modifier 22, according to the Centers for Medicare & Medicaid Services (CMS) Medicare Carriers Manual (section 4822, A.10). Appendix A of the CPT® Manual likewise advises that modifier 22 is appropriate “when the work required to provide a service is substantially greater than typically required.”

To read more about modifier 22, read the full article here.


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