Teaching Physicians and Residents: Expansion of CPT Codes that May Be Billed with the GE Modifier

Teaching physicians and residents: Expansion of CPT codes that may be billed with the GE HCPCS modifier under 42 CFR 415.174 on and after March 1, 2020, for the duration of the public health emergency:

  • Residents furnishing services at primary care centers may provide an expanded set of services to beneficiaries, including levels 4-5 of an office/outpatient Evaluation and Management (E/M) visit, telephone E/M, care management, and some communication technology-based services
  • This expanded set of services are CPT codes 99204-99205, 99214-99215, 99495-99496, 99421-99423, 99452, and 99441-99443 and HCPCS codes G2010 and G2012
  • Teaching physicians may submit claims for these services furnished by residents in the absence of a teaching physician using the GE HCPCS modifier

Medicare Administrative Contractors will automatically reprocess claims billed with the GE HCPCS modifier on or after March 1, 2020, that were denied. You do not need to do anything.