Report modifier 52 to a partially reduced or eliminated service. The modifier provides a means for reporting reduced services without disturbing the identification of the basic service. It also identifies a situation where a physician reduces or eliminates a portion of a service or procedure.

• Don't use modifier 52 when there is a CPT code that accurately describes the service(s) performed.
• Inappropriate with E/M codes
• Facilities reporting discontinued procedures should use modifier 73 or 74.

Modifier 52 reimbursement

Reimbursement under all plans will be 50% of the base fee schedule. This does not include MSD reduction, bilateral pricing, etc. that may also be applied.

Priority Health may request notes to determine the extent of services rendered.

Reference the CPT Manual for additional instruction.