Medicaid with Mod 91

[bwalters]

Hi,

Does anybody know if GA Medicaid does not accept modifier -91 for Lab CPTs under category of service 70 when billed as hospital outpatient.

 

[Deborah Marsh]

Hi - I couldn't find anything that specific, but Amerigroup who offers Medicaid in Georgia mentions 91 can be for physician or facility use (https://provider.amerigroup.com/docs/gpp/GA_RP_ModifierUsage.pdf). Their policy for mod 91 doesn't mention category of service 70 as a reason for exclusion (https://provider.amerigroup.com/docs/gpp/GA_RP_Modifier91RepeatLabTest.pdf).

If someone else has knowledge of this issue, please share

 

[bwalters]

Hi - I couldn't find anything that specific, but Amerigroup who offers Medicaid in Georgia mentions 91 can be for physician or facility use (https://provider.amerigroup.com/docs/gpp/GA_RP_ModifierUsage.pdf). Their policy for mod 91 doesn't mention category of service 70 as a reason for exclusion (https://provider.amerigroup.com/docs/gpp/GA_RP_Modifier91RepeatLabTest.pdf).

If someone else has knowledge of this issue, please share

Thank you