HCPCS Modifier QZ

Published 07/16/2020

Certified Registered Nurse Anesthetist (CRNA) service without medical direction by a physician.

Guidelines and Instructions for the QZ HCPCS Modifier

  • This modifier may only be submitted with anesthesia procedure codes (i.e., CPT codes 00100 through 01999). Payment for services that meet the definition of personally performed is based on the base units as defined by CMS and time, in increments of 15-minute units.
  • If you are submitting multiple modifiers, submit this modifier first

Note: This modifier may not be appended to a service performed by an Anesthesiologist Assistant (AA).


  • CMS Internet Only Manuals, Pub. 100-04, Chapter 12 (PDF, 1.10 MB)
    • Definitions of personally performed, medically directed and medically supervised: Section 50
    • Definition of concurrent procedures: Section 50.C
    • Anesthesia claims modifiers: Section 50.I
    • Billing modifiers for qualified nonphysician anesthetists: Section 140.3.3

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