Do you use Modifier AI when billing Medicare?

Written by Reed Tinsley | October 3, 2017

 

Modifier AI is used to identify the principal physician of record. It is an informational modifier.

Appropriate Use

To identify admitting or attending physician who oversees the patient’s care during a hospital admission;
Admitting physician appends to the initial inpatient hospital care evaluation and management service (99221-99223);
Admitting physician appends to the initial nursing facility evaluation and management service (99304-99306); and
Append after payment modifiers

Inappropriate Use

Reported by any physician other than attending or admitting physician who oversees the patient’s care during the hospital, or nursing home admission; and
Reported on procedures codes other than 99221-99223 and 99304-99306

References

Medicare Learning Network (MLN) Matters Article, MM6740 - Revisions to Consultation Services Payment Policy
MLN Matters Special Edition, SE1010 - Questions and Answers on Reporting Physician Consultation Service

About the Author

Reed Tinsley CPA

This article is written by Reed Tinsley, a Houston, TX-based CPA with over 30 years of experience advising physicians and medical practices across Texas and the United States. Reed holds certifications as a Certified Valuation Analyst (CVA), Certified Healthcare Business Consultant (CHBC), and Certified Financial Planner (CFP), specializing exclusively in the healthcare sector. He is a published author, nationally recognized speaker, and trusted advisor to physicians on accounting & tax, practice management, and financial planning. Schedule a Free Consultation.

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