Revenue Cycle Insider

Question: Can you tell me if a GC modifier for residents is only required by Medicare, or by any payer that requires medical direction modifiers? For example, I am a bit confused whether BCBS will need the GC if a client bills an AA modifier or AA GC modifiers for one-on-one cases (MD overseeing one resident).

Florida Subscriber

Answer: The GC modifier (This service has been performed in Part by a Resident under the Direction of a Teaching Physician) is required by Medicare and can be reported for up to two residents. GC should not affect payment for anesthesia services. Not all policies address whether the GC modifier is accepted while some payers ask for a GC modifier in their guidelines. If required by policy, you should append a GC modifier to the services the same as a Medicare claim. However, payers should not reduce payment for anesthesia services reported with these modifiers.

Kelly D. Dennis, MBA, ACS-AN, CANPC, CHCA, CPMA, CPC,
CPC-I, Perfect Office Solutions, Contributing Writer