When to Use Modifier SA

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.

John Verhovshek

John Verhovshek

John Verhovshek, MA, CPC, is Managing Editor at AAPC. He has covered medical coding and billing, healthcare policy, and the business of medicine since 1999. He is an alumnus of York College of Pennsylvania and Clemson University, and a member of the Asheville-Hendersonville AAPC Local Chapter.
John Verhovshek

About Has 474 Posts

John Verhovshek, MA, CPC, is Managing Editor at AAPC. He has covered medical coding and billing, healthcare policy, and the business of medicine since 1999. He is an alumnus of York College of Pennsylvania and Clemson University, and a member of the Asheville-Hendersonville AAPC Local Chapter.

5 Responses to “When to Use Modifier SA”

  1. Barbara J. Cobuzzi says:

    United Healthcare has indicated that the SA modifier be used for APP services provided under collaboration, billing under the Physician’s NPI starting 9/1/2017. United Health wants the practice to put the rendering provider’s NPI in box 24J.

  2. Kelly Secreto says:

    “SA” can’t be used for inpatient can it?

  3. Chris Gray says:

    Barbara Cobuzzi ,
    Can you tell me the source you found that the SA modifier is needed for United Healthcare?
    Appreciate your help in this matter. Thank you.

  4. penny says:

    I am very new to the field and currently working in a billing office for multiple practices who use nurse practitioners. Can you clarify for me:
    A NP performs an E/M service, what npi number goes in box 24 j–the nurse practitioner or doctor? I called UnitedHealthCare, and was told no one knows what I am talking about when questioning the sa modifier-

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