If a patient is being transported to a wound care center located within a hospital or on hospital grounds, which destination modifier would be used when filing the claim?

Answer:
This depends on how the facility is licensed. If it is licensed as a physician’s office, then the appropriate HCPCS modifier would be P. If it is licensed as a hospital, then you would use HCPCS modifier H. If the facility is licensed as neither a physician’s office nor a hospital, then HCPCS modifier D (Diagnostic or therapeutic site other than P or H) would be appropriate. You will need to verify this with the wound care center.

Please Note: HCPCS modifier D would also be appropriate for an independent diagnostic testing facility, cancer treatment center or radiation therapy center. 

Resource:

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Provider Contact Center: 888-355-9165

IVR: 877-288-7600

TTY: 877-715-6397

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