HCPCS Modifier FY

Description
Computed radiography X-ray.

Guidelines/Instructions

  • This modifier is effective for services provided on or after January 1, 2018
  • Providers must submit this modifier with the X-ray CPT code for each X-ray taken using computed radiography
  • Effective for claims with dates of service on and after January 1, 2018 through December 31, 2022, a seven percent payment reduction applies to the technical component (and the technical component of the global fee) of the MPFS amount when an X-ray procedure is taken using computed radiography and billed with HCPCS modifier FY
  • Effective for claims with dates of service on and after January 1, 2023, a 10 percent payment reduction applies to the technical component (and the technical component of the global fee) of the MPFS amount when an X-ray procedure is taken using computed radiography and billed with HCPCS modifier FY
  • Use of HCPCS modifier FY for these services will result in the applicable payment reduction
  • The beneficiary is not liable for the FY HCPCS modifier payment reduction
  • When the payment reduction is made, the following remittance messages will be used:
    • Claim Adjustment Reason Code (CARC) 237 — Legislated/Regulatory Penalty
    • Remittance Advice Remark Code (RARC) N794 — Payment adjusted based on type of technology used
    • Group Code: CO (contractual obligation)

Resource: CMS MLN Matters® Article MM10188 (PDF, 198 KB).

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