HCPCS Modifier GJ
Opt-out physician or practitioner emergency or urgent service.
Guidelines and Instructions
- Physicians that have opted out of Medicare (also called private contracting) are not permitted to submit services to Medicare; however, the exception to this rule is when services provided on an emergent or urgent basis. Opt-out physicians and practitioners must submit these services to Medicare with HCPCS modifier GJ.
- In order to opt-out of Medicare, physicians and practitioners that are permitted to opt-out must follow certain procedures and guidelines