Hemodialysis Modifier Requirement

Date: 06/01/23

Medicare and Marketplace dialysis claims for dates of service 7/1/2023 and after will be edited prior to payment to confirm modifier G1, G2, G3, G4, G5, or G6 is billed with 90999 (unlisted dialysis procedure).

This edit is being implemented to process claims in accordance with Medicare standards, i.e. Medicare Claims Processing Manual Chapter 8 - Outpatient ESRD Hospital Independent Facility, and Physician/Supplier Claims; Section 50.9 - Coding for Adequacy of Dialysis, Vascular Access, and Infection for Hemodialysis Modifier (PDF).