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Enhancing Access and Payment Through Proper Use of Modifiers

CHRISTIAN HERMANSEN, MD, MBA
DORETTA HESS, BSHA, CCS-P

FPM. 2026;33(2):11-16.

Author disclosures: no relevant financial relationships.

This content conforms to AAFP criteria for CME.

Primary care physicians can get the revenue they deserve by properly using codes that indicate they provided multiple services in a single patient encounter.

Family physicians often perform multiple services in a single patient encounter. This provides access to comprehensive care with a convenience that both the physician and patient appreciate. But physicians do not get paid for all of their work if they don't attach the correct modifiers in the office encounter.

Modifiers have many purposes and applications. They can indicate when an encounter has both professional and technical components, when a procedure was partially completed or discontinued, and when multiple procedures or services are provided on the same date. Using a modifier does not always result in physicians receiving complete reimbursement for every service as requested, but may allow for at least partial payment. Some estimates indicate that missed modifiers could result in up to $120 of lost revenue per applicable visit.1 This can be very costly when you consider that family physicians see 60–80 office visits per week on average.2

This article explains how to use some of the modifiers most common in primary care, which are also listed in Table 1.

KEY POINTS

  • Modifier 25 is a “multitasking modifier” that indicates to the payer that the clinician performed separate but significant services to the patient in one encounter.
  • Services partially completed or discontinued can still be billed using modifier 52 and modifier 53, respectively.
  • Modifiers may be required when reporting telemedicine services, including audio-only. But these rules are in flux post-pandemic and it's best to check with individual payers.

TABLE 1. LIST OF MODIFIERS AND DEFINITIONS

Alphanumeric code Definition
24 Unrelated E/M service by the same physician in the postoperative period
25 Separate, significantly identifiable E/M services
26 Only performed professional component (PC)
50 Bilateral procedures
52 Reduced services (e.g., bilateral code performed unilaterally)
53 Discontinued procedure
59 Distinct procedural services on the same day that are not normally reported together
76 Repeat procedure, same physician
77 Repeat procedure, another physician
PC Professional component
TC Technical component

Dr. Hermansen is faculty at the Penn Medicine Lancaster General Health Family Medicine Residency Program and managing physician of Family Medicine Downtown in Lancaster, Pa.

Doretta Hess is the coding director for Axia Women's Health and former coding director at Penn Medicine Lancaster General Health Physicians.

The opinions and views expressed in this article are solely those of the author and do not represent or reflect the views of Axia Women's Health. Axia Women's Health has not reviewed or approved this content and accepts no responsibility or liability for any statements, errors, or omissions herein.

Author disclosures: no relevant financial relationships.

  1. 1.Family practice medical billing for faster payment. Annex Med. May 28, 2025. Accessed Jan. 28, 2026. https://annexmed.com/family-practice-medical-billing
  2. 2.Table 6: Average number of family physician patient encounters per week by setting. American Academy of Family Physicians (AAFP). Accessed Jan. 28, 2026. https://www.aafp.org/about/dive-into-family-medicine/family-medicine-facts/table6.html
  3. 3.2025 Medicare NCCI Policy Manual — Chapter 1. American Medical Association. Revised Feb. 28, 2025. Accessed Jan. 28, 2026. https://www.cms.gov/files/document/01-chapter1-ncci-medicare-policy-manual-2025finalcleanpdf.pdf
  4. 4.How to code for telehealth: audio-video, audio-only and virtual-digital visits. AAFP. Accessed Jan. 28, 2026. https://www.aafp.org/family-physician/practice-and-career/getting-paid/coding/coding-telehealth-audio-virtual-digital-visits.html
  5. 5.Medicare NCCI procedure to procedure (PTP) edits. CMS. Modified Dec. 2, 2025. Accessed Feb. 16, 2026. https://www.cms.gov/medicare/coding-billing/national-correct-coding-initiative-ncci-edits/medicare-ncci-procedure-procedure-ptp-edits

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