Wiki Modifier GC and non-Medicare plans

[alincoln]

Can anyone offer any advice on whether non-medicare plans require the GC/GE modifiers?

I'm also trying to find documentation on how commerical medicare plans handle the GC/GE modifiers.

Thank you!

 

[Evelyn Kim]

it has always been by understanding that the GC/GE were limited to Medicare. I could be wrong, but we were always told to only use them for CMS claims that commercial payers would not recognize them.

The modifers are to identify residents who are involved in a federally funded teaching plan, and the teaching physician is asking for federal funds from CMS through Medicare.

It would be best to contact the individual commercial plans to see if they will accept the modifiers.

 

[kevbshields]

Ask you plans, as someone else mentioned; my understanding has always been that it applies to all Federal payers, not just Medicare. However, the private payers ought to be requiring it (personal opinion) to help them monitor compliance with teaching physician-resident guidelines.