Wiki GC Modifier-According to Medicare

[edixon]

According to Medicare teaching physician guidelines, the GC modifier is appended to an office visit if a “service has been performed in part by a resident under the direction of a teaching physician.” If a teaching physician sees a patient for an office visit with a resident present, with the resident observing only, would the GC modifier be required with the physician bill? Also, supporting information anyone may be able to cite for this would be very much appreciated.

Ellen

 

[ajs]

From what I read in the Medicare guidelines, if the resident was just observing there is no need for the GC modifier. The modifier is intended to show that the resident performed key portions of the service and that the teaching physician was present to guide the resident. If the resident did not perform any portion of the service, then no need for a modifier.

 

[kevbshields]

Explain how you would know if the Resident was present? Who documented the care?

In my experience, teaching providers try to "fudge" these rules.