HCPCS Modifier FY

Description
Computed radiography X-ray.

Guidelines and Instructions

• This modifier is effective for services provided on or after January 1, 2018
• Providers must submit this modifier with the X-ray CPT® code for each X-ray taken using computed radiography
• Effective for claims with dates of service on and after January 1, 2018, through December 31, 2022, a seven percent payment reduction applies to the technical component (and the technical component of the global fee) of the MPFS amount when an X-ray procedure is taken using computed radiography and billed with HCPCS modifier FY
• Effective for claims with dates of service on and after January 1, 2023, a 10 percent payment reduction applies to the technical component (and the technical component of the global fee) of the MPFS amount when an X-ray procedure is taken using computed radiography and billed with HCPCS modifier FY
• Use of HCPCS modifier FY for these services will result in the applicable payment reduction
• The beneficiary is not liable for the FY HCPCS modifier payment reduction
• When the payment reduction is made, the following remittance messages will be used:
  • Claim Adjustment Reason Code (CARC) 237 — Legislated/Regulatory Penalty
  • Remittance Advice Remark Code (RARC) N794 — Payment adjusted based on type of technology used
  • Group Code: CO (contractual obligation)

Resource: CMS MLN Matters® Article MM10188 (PDF).