HCPCS Modifier G

Description
Hospital-based dialysis facility (hospital or hospital related).

Guidelines/Instructions

  • Submit this modifier to indicate the origin or destination of an ambulance transport, when the location is a hospital-based dialysis facility
  • Additional documentation may be required to support the need for this ambulance trip 
References

Contact Palmetto GBA JM Part B Medicare

Email Part B

Contact a specific JM Part B department

Provider Contact Center: 855-696-0705

TDD: 866-830-3188

Other Palmetto GBA Sites

Palmetto GBA Home

DMEPOS Competitive Bidding Program

Jurisdiction J Part A MAC

Jurisdiction J Part B MAC

Jurisdiction M Part A MAC

Jurisdiction M Part B MAC

Jurisdiction M Home Health and Hospice MAC

MolDX

National Supplier Clearinghouse MAC

PDAC

RRB Specialty MAC Providers

RRB Specialty MAC Beneficiaries

Anonymous

 

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