01062416
Guest
Does anyone know of a list or calculation for RVU's for
62 or 80 Modifiers
62 or 80 Modifiers
-
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Wiki RVU's for 62 and 80 Modifier
- Thread starter 01062416
- Start date
cpccaperton
Guru
Medicare Claims Processing Manual: Chapter 12 - Physicians/Nonphysician Practitioners
Section 40.8. Claims for Co-Surgeons and Team Surgeons
(Rev. 1, 10-01-03)
B3-4828, B3-15046
For co-surgeons (modifier 62), the fee schedule amount applicable to the payment for each co-surgeon is 62.5 percent of the global surgery fee schedule amount.
Section 20.4.3 - Assistant at Surgery Services
(Rev. 1, 10-01-03)
B3-15044
For assistant at surgery services performed by physicians, the fee schedule amount equals 16 percent of the amount otherwise applicable for the global surgery.
Carriers may not pay assistants at surgery for surgical procedures in which a physician is used as an assistant at surgery in fewer than five percent of the cases for that procedure nationally. This is determined through manual reviews.
In addition to the assistant at surgery modifiers “-80,” “-81,” or “-82,” any procedures submitted with modifier AS are subject to the assistant surgeon's policy enunciated in the Medicare physician fee schedule database (MPFSDB). Accordingly, pay claims for procedures with these modifiers only if the services of an assistant surgeon are authorized.
Section 110.3 - PA Billing to Carrier
(Rev. 1, 10-01-03)
B3-16001, B3-15044, B3-2156, PM-B-99-16
A. Modifiers
Physician Assistant as assistant at surgery should be identified with a modifier AS. Billers must identify PA assistant-at-surgery services with the following modifiers as applicable:
Assistant surgeon services billed with modifier “-80”;
Minimum assistant surgeon services with modifier “-81”;
Assistant surgeon services (when assistant resident surgeon not available) with modifier 82.
NOTE: 80, 81, and 82 are paid at 65 percent of 16 percent. No other reductions for minimum services take place.
Section 40.8. Claims for Co-Surgeons and Team Surgeons
(Rev. 1, 10-01-03)
B3-4828, B3-15046
For co-surgeons (modifier 62), the fee schedule amount applicable to the payment for each co-surgeon is 62.5 percent of the global surgery fee schedule amount.
Section 20.4.3 - Assistant at Surgery Services
(Rev. 1, 10-01-03)
B3-15044
For assistant at surgery services performed by physicians, the fee schedule amount equals 16 percent of the amount otherwise applicable for the global surgery.
Carriers may not pay assistants at surgery for surgical procedures in which a physician is used as an assistant at surgery in fewer than five percent of the cases for that procedure nationally. This is determined through manual reviews.
In addition to the assistant at surgery modifiers “-80,” “-81,” or “-82,” any procedures submitted with modifier AS are subject to the assistant surgeon's policy enunciated in the Medicare physician fee schedule database (MPFSDB). Accordingly, pay claims for procedures with these modifiers only if the services of an assistant surgeon are authorized.
Section 110.3 - PA Billing to Carrier
(Rev. 1, 10-01-03)
B3-16001, B3-15044, B3-2156, PM-B-99-16
A. Modifiers
Physician Assistant as assistant at surgery should be identified with a modifier AS. Billers must identify PA assistant-at-surgery services with the following modifiers as applicable:
Assistant surgeon services billed with modifier “-80”;
Minimum assistant surgeon services with modifier “-81”;
Assistant surgeon services (when assistant resident surgeon not available) with modifier 82.
NOTE: 80, 81, and 82 are paid at 65 percent of 16 percent. No other reductions for minimum services take place.