Question: Missouri Subscriber Answer: Since this is not a Medicare patient, you do not need a modifier unless your physician is taking the patient to the operating room or going to do a minor procedure. If he takes the patient to the operation room, append modifier 57 (Decision for surgery). For a minor procedure, use modifier 25 (Significant, separately identifiable evaluation and management service by the same physician on the same day of the procedure or other service). If the patient is in the global period of a procedure you'll need to append modifier 24 (Unrelated evaluation and management service by the same physician during a postoperative period). Don't miss: For example, Washington Medicaid requires you to append AI when the patient has both Medicare and Medicaid but not for patients with Medicaid only. Make sure you know what your payers want and follow those rules when submitting claims.