HCPCS 'G' Modifiers (35)

CodeDescription
G0Telehealth services for diagnosis, evaluation, or treatment, of symptoms of an acute stroke
G1Most recent urr reading of less than 60
G2Most recent urr reading of 60 to 64.9
G3Most recent urr reading of 65 to 69.9
G4Most recent urr reading of 70 to 74.9
G5Most recent urr reading of 75 or greater
G6Esrd patient for whom less than six dialysis sessions have been provided in a month
G7Pregnancy resulted from rape or incest or pregnancy certified by physician as life threatening
G8Monitored anesthesia care (mac) for deep complex, complicated, or markedly invasive surgical procedure
G9Monitored anesthesia care for patient who has history of severe cardio-pulmonary condition
GAWaiver of liability statement issued as required by payer policy, individual case
GBClaim being re-submitted for payment because it is no longer covered under a global payment demonstration
GCThis service has been performed in part by a resident under the direction of a teaching physician
GDUnits of service exceeds medically unlikely edit value and represents reasonable and necessary services
Terminated: December 31, 2019
GEThis service has been performed by a resident without the presence of a teaching physician under the primary care exception
GFNon-physician (e.g. nurse practitioner (np), certified registered nurse anesthetist (crna), certified registered nurse (crn), clinical nurse specialist (cns), physician assistant (pa)) services in a critical access hospital
GGPerformance and payment of a screening mammogram and diagnostic mammogram on the same patient, same day
GHDiagnostic mammogram converted from screening mammogram on same day
GJ"opt out" physician or practitioner emergency or urgent service
GKReasonable and necessary item/service associated with a ga or gz modifier
GLMedically unnecessary upgrade provided instead of non-upgraded item, no charge, no advance beneficiary notice (abn)
GMMultiple patients on one ambulance trip
GNServices delivered under an outpatient speech language pathology plan of care
GOServices delivered under an outpatient occupational therapy plan of care
GPServices delivered under an outpatient physical therapy plan of care
GQVia asynchronous telecommunications system
GRThis service was performed in whole or in part by a resident in a department of veterans affairs medical center or clinic, supervised in accordance with va policy
GSDosage of erythropoietin stimulating agent has been reduced and maintained in response to hematocrit or hemoglobin level
GTVia interactive audio and video telecommunication systems
GUWaiver of liability statement issued as required by payer policy, routine notice
GVAttending physician not employed or paid under arrangement by the patient's hospice provider
GWService not related to the hospice patient's terminal condition
GXNotice of liability issued, voluntary under payer policy
GYItem or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
GZItem or service expected to be denied as not reasonable and necessary