Reimbursement policy update - Modifier 66: Surgical Teams (Professional)
Modifier 66: Surgical Teams - Professional
Under this reimbursement policy, Empire BlueCross BlueShield (Empire) allows the procedures eligible for surgical teams when billed with modifier 66.
Empire follows the Centers for Medicaid and Medicare Services (CMS) Medicare physician fee schedule (MPFS) team surgery payment indicators and will allow services requiring team surgery billed with CMS MPFS payment indicator 1 (sometimes) and 2 (always) and will deny services billed with the indicator 0 (never) and 9 (not applicable).
September 2022 Newsletter