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Thread: PT Modifier - CMS

  1. #1

    Default PT Modifier - CMS

    AAPC: Back to School
    Does anyone have any information on the use of the PT modifier for screening procedures (GI) as of 1/1/11. I am unable to locate anything on CMS and a lot of our commercial payers & Medicare managed care plans know nothing about this modifier. Any help is appreciated. Thanks,

  2. #2
    Join Date
    Apr 2007


    The PT modifier information is located in the MLN Matters number MM7012 release date 07/30/10. Not sure if that helps or not. The good thing is that if the patient comes in for a screening colon and then becomes diagnostic, append the PT modifier and the deductible and the co-ins are still waived as if it were a screening.

  3. #3


    from what i understand it is only the deductible that is waived, not the coinsurance

  4. #4
    Join Date
    Apr 2007
    Columbia, MO


    That is correct it is the deductible that is waived.

    Debra A. Mitchell, MSPH, CPC-H

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