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Ask a Rev Cycle Expert: Use of Modifier PN?


Does the PN modifier reduction in reimbursement for off campus PBD apply to more services then the G0463?


The use of Modifier PN, Non-excepted service provided at an off-campus, outpatient, provider-based department of a hospital, will trigger a reduced payment rate that is currently equal to 40% of the Ambulatory Payment Classification (APC) payment rate for all procedures that are currently reimbursed via APC. Modifier PN should be applied to each claim line item, including those that will not be adjusted to the Medicare Physician Fee Schedule (MPFS) rate. Items such as separately payable drugs, clinical laboratory tests and therapy services are not reduced but should still have the modifier applied.

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