Applying this modifier alerts Medicare that you know the service isn’t covered.
To estimate what your practice should charge a Medicare patient when your ob-gyn performs a preventive service as well as an E/M service at the same visit means applying the “carve out” rule. Depending on whether the patient’s annual exam is covered, your outcome will be very different.
Our experts break this sometimes puzzling rule into terms you can understand.
Follow This Advice for Medicare Carriers
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