32 Modifier (Mandated Services) - Help Prevent a Redetermination Request

Modifier 32 indicates mandated services. This modifier is not appropriate when billing Medicare for federally mandated visits for patients in a Skilled Nursing Facility (SNF) or Nursing Facility (NF). Medicare can make payment for these federally mandated services based on the Centers for Medicare & Medicaid Services (CMS) Internet-Only Manual (IOM) Publication 100-04, Chapter 12, Section 30.6.13.B.

Providers should use Modifier 32 only when reporting a service mandated by an outside entity such as an insurance company, employer, etc. WPS Medicare will deny all services submitted with a modifier 32. If Modifier 32 is appropriate for the situation, you should not need to request a redetermination.

Page Last Updated: Friday, 04-Dec-2009 13:49:12 CST