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GY - JE Part A

Modifier GY


Item or service statutorily excluded, does not meet the definition of any Medicare benefit.

Appropriate Usage

  • Append when services are provided under statutory exclusion from Medicare Program; claim would deny whether or not modifier is present on claim
  • It is not necessary to provide patient with an ABN for these situations
  • Situations excluded based on a section of the Social Security Act
  • Non-covered ambulance mileage reported on HCPCS A0888
  • Append to cause claim to deny with patient liable for charges

Inappropriate Usage

  • Appending to bundled procedures
  • Appending to add-on codes



Last Updated Fri, 16 Dec 2022 18:52:01 +0000