Modifier For Medicaly Directed/Suervised Anesthesia Services

Medically Directed / Supervised


MODIFIER MODIFIER NARRATIVE PROVIDER TYPE ADDITIONAL MEDICARE INFORMATION

AD 
Medical Supervision by a physician, more than four (4) concurrent anesthesia procedures
Anesthesiologist
Allow three (3) base units, and one (1) additional base unit when it is demonstrated that the physician was present at the induction

QK
Medical direction of two, three, or four concurrent anesthesia procedures involving qualified individuals
Anesthesiologist
Reimbursed at 50% of the Medicare allowed amount

QY
Medical direction of one CRNA / AA by an anesthesiologist
Anesthesiologist
Reimbursed at 50% of the Medicare allowed amount

QX
CRNA service with medical direction by a physicians
CRNA / AA
Reimbursed at 50% of the Medicare allowed amount

GC
Services performed by a Resident under the direction of a teaching physician
Anesthesiologist
The GC modifier is reported by the teaching physician to indicate they rendered the service in compliance with Chapter 12, Section 100.1.2 of Medicare’s Claims Processing Manual.

Personally Performed
AA
Anesthesia Services personally performed by the anesthesiologist
Anesthesiologist
Reimbursed at 100% of the Medicare allowed amount

QZ
CRNA service without medical direction by a physician
CRNA / AA
Reimbursed at 100% of the Medicare allowed amount