In the Final Rule, citing authority under Social Security Act § 1833(t)(2)(F), CMS finalized a policy to pay the lower site-neutral PFS payment rate for clinic visit services (HCPCS code G0463) billed with the “PO” claims modifier (now required for all off-campus PBDs of a ...
The agency states that the code will not be payable when an office visit is reported with modifier 25 or bundled with another service. Also, the code "would not be appropriately reported, such as when the care furnished during the [office] E/M visit is provided by a profession...
1, 2023, the "JG" modifier will be used by hospitals (except rural sole community hospitals, children's hospitals and Prospective Payment System (PPS)-exempt cancer hospitals, all of which will continue to use the "TB" modifier) to identify 340B drugs for informational purposes...