HCPCS Modifier GG

Description
Payment screen mam + diagmam.

Guidelines/Instructions
Medicare allows additional mammogram films to be performed without an additional order from the treating physician.
  • When the radiologist interpretation of screening mammography results in the performance of diagnostic mammography on the same day for the same patient, both tests will be reimbursed
  • Submit HCPCS modifier GG with the diagnostic mammography code
  • This modifier is required for tracking and data collection purposes
This modifier may be submitted with the following codes:
  • CPT codes: 77065 and 77066 
  • HCPCS codes: G0204 and G0206 (Note: G0204 and G0206 are no longer valid for dates of service January 1, 2019, and after)

Reference: CMS Internet Only Manual: Claims Processing Manual 100-4, Chapter 18 Preventive and Screening Services, Section 20 Mammography (PDF, 1.22 MB).

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Provider Contact Center: 855-696-0705

TDD: 866-830-3188

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