Modifiers

Modifiers

The ANSI Standard Modifiers can be modified to change the Fee when the Modifier is used.

The ANSI Standard Modifiers are pre-populated in the System. These Modifiers can be edited to increase or decrease the Fee on a Charge.


  1. From Libraries on the Left Side Menu, choose Modifiers.

  1. Select the Modifier link.

  1. Modifier: The Modifier field can only be modified if it has not been used.
  2. Description: The Description can be changed to meet your needs.
  3. Effective and Expiration: These can be used to qualify the Dates that this Modifier can be used.
  4. Non-Billable: Select this the checkbox to prevent this Modifier from being submitted on a Claim. It will be used for reporting purposes only.
  5. Rules: 
  • Select Increase or Decrease to change the fee when the Modifier is used.
  • Leave it as Select if the fee should not be changed.
  1. Procedure Fee by: Enter the percentage to increase or decrease the fee amount.
  2. Round: The field defaults to Up and will round the fee up.
  • Select Down to round the fee down.
  1. To the nearest: Defaults to $1.00 but can be changed.
  2. Select Save [F2].

Increase or Decrease a Fee using a Modifier

Use the Modifier Rules above to increase or decrease the fee by a specific percentage.

Example 1: The CPT code has a Modifier 50, and the Modifier Rules are set up for the fee to decrease by 50%.

  • A fee decrease is indicated by a red shaded background.


Example 2: The CPT code has a Modifier 51, and the Modifier Rules are set up for the fee to increase by 25%.

  • A fee increase is indicated by a green shaded background.


Use a Modifier to Apply a Self Pay Discount

A Custom Modifier can be added to apply a discount to a Self Pay Patient. Apply a Self Pay Discount.


Learn More

Add a Modifier to a Procedure Code



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