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Modifier XE vs. 59

  1. #1
    Post Modifier XE vs. 59
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    I'm looking for guidance on when to use modifier XE vs. modifier 59. For example, an ABA client is seen in the morning for 60 mins for behavior treatment (0364T - first 30 mins & 0365T - additional 30 mins). The client is then also seen later that day for the same service (0365T). Services are provided on same date of service, same code, same provider. Should the afternoon session of 0365T be billed with modifier XE or 59?

    Any help is greatly appreciated!

  2. #2
    Harrisburg Pennsylvania Chapter
    XE is the modifier to use when billing Medicare (and maybe Medicaid), mod 59 is used for commercial insurance companies.

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