When to Use Modifier SA
You should use modifier SA Nurse practitioner rendering service in collaboration with a physician for supervised NP services, when the insurer requires the modifier. Medicare does not accept modifier SA, and other payers may specify unique requirements. For example, Blue Cross/Blue Shield Texas calls for modifier SA when a supervising physician bills on behalf of a PA, adult nurse practitioner (ANP), or certified registered nurse first assistant (CRNFA) for non-surgical services (which could include E/M services). Contact your payer for specifics.