CPT & HCPCS
CPT modifiers explained
Modifiers are two-character codes appended to CPT and HCPCS codes to tell the payer that a service was altered in some way (performed separately, split into components, repeated, or delivered by telehealth) without changing the code itself. Used correctly they unlock legitimate payment; used loosely they are the most audited codes in billing. Each page below explains one modifier in plain English.
Evaluation & management
| Modifier | What it means |
|---|---|
| Modifier 25 | Significant, separately identifiable E/M service |
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Bundling & distinct services
| Modifier | What it means |
|---|---|
| Modifier 59 | Distinct procedural service |
Modifiers 26 and TC split a code into professional and technical components: the RVU split is shown on each RVU reference page. Misused modifiers usually surface as bundling denials on the remit; see the denial codes index.