Diagnostic or therapeutic site other than "P" or "H" when these are used as origin codes (treatment facility).

Guidelines and Instructions
  • Submit this modifier to indicate the origin or destination of an ambulance transport, when the location is a diagnostic or therapeutic site other than a physician's office or hospital
  • This origin/destination modifier is also used to signify transport to/from a treatment facility other than a dialysis facility. For transport to/from a dialysis facility, refer to HCPCS origin modifiers G and J.
  • Additional documentation may be required to support the need for this ambulance trip

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Provider Contact Center: 877-567-7271

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