GW Modifier Billing Reminder

Effective for claims submitted on or after December 1, 2020, with a date of service on or after September 7, 2020, if a beneficiary is currently enrolled in hospice and is provided a Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) item not related to their hospice condition, the GW modifier must be appended to the applicable HCPCS codes.

When a claim is submitted after December 1, 2020, with a date of service on or after September 7, 2020, without the GW modifier for a beneficiary enrolled in hospice, the claim will be denied. These claims can be corrected through the Noridian Medicare Portal or resubmitted with the GW modifier.

If there are more than four modifiers required to be appended to the same HCPCS code, replace the fourth modifier with modifier 99 and add the excess modifiers to Item 19 of the CMS-1500 claim form.

 

            Last Updated Thu, 19 Nov 2020 19:41:30 +0000