AS - JE Part B

Physician Assistant (PA), Nurse Practitioner (NP) or Clinical Nurse Specialist (CNS) assistant at surgery services.

Instructions

Append this modifier to appropriate procedure codes when Non-Physician Practitioners (NPPs) are assisting a principal surgeon as an assistant surgeon. The assistant at surgery provides more than ancillary services. NPPs include a CNS, NP and PA.

Correct Use

• The Medicare Physician Fee Schedule (MPFS) Indicator/Descriptor lists under column A will confirm if assistant at surgery is allowed.
  • 2 = payment restriction for assistants at surgery does not apply to this procedure. Assistant surgeon may be paid).
• NPP, mid-level practitioner or advance practice practitioner (APP)
  • Append this modifier only
• NPP must accept assignment
• NPPs are allowed 85% of 16% physician fee allowable or 14% of surgery

Incorrect Use

• Inappropriate for NPPs to use modifiers 80, 81 or 82 (physician only modifiers)
• Modifier 80 (assistant surgeon), 81 (minimum assistant surgeon) or 82 (qualified resident surgeon not available) with physician (MD/DO) assisting at surgery

Resources

• CMS Internet Only Manual (IOM), Publication 100-04, Medicare Claims Processing Manual, Chapter 12, Section 20.4.3
• CMS IOM, Publication 100-04, Medicare Claims Processing Manual, Chapter 26, Section 10.7