Description
Catastrophe/disaster related.

Guidelines/Instructions

  • HCPCS modifier CR is used by Medicare to track and facilitate claims processing for disaster victims
  • This modifier may only be submitted with services that are related to a disaster or catastrophe, such as Hurricane Katrina in 2005
  • Submit as much information as possible with these claims so that we may determine coverage
  • Effective August 31, 2009: use of HCPCS modifier CR will be mandatory for applicable HCPCS codes on any claim for which Medicare Part B payment is conditioned on the presence of a "formal waiver"
  • HCPCS modifier CR also may be required for any HCPCS code for which, Medicare claims processing contractor's discretion or as directed by CMS in a disaster or emergency
Special instructions for H1N1 situations
  • On July 31, 2009, CMS issued Transmittal 1784 (CR 6451) which, among other things, narrowed the scope of permitted uses of these indicators. In particular, it eliminated the discretionary use of both the DR condition code and HCPCS modifier CR by providers and suppliers.
  • For the H1N1 pandemic emergency, CMS has authorized the use of the DR condition code and HCPCS modifier CR only by providers that have been granted a formal waiver under § 1135 of the Social Security Act and then only for services affected by the emergency and while the waiver remains in effect. No other provider or supplier may use either indicator at this time.

References

Contact Palmetto GBA JJ Part B Medicare

Provider Contact Center: 877-567-7271

Email JJ Part B

Contact a specific JJ Part B department



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