What is modifier 33?

Modifier 33 is a CPT modifier used in healthcare billing to indicate that a preventive service was provided at no cost to the patient due to requirements outlined in the Affordable Care Act. This modifier ensures that the service is billed correctly and the patient is not charged for the preventive service.

The Affordable Care Act mandates that certain preventive services be covered by insurance plans without cost-sharing requirements such as copayments or deductibles. These services include screenings, vaccinations, and counseling for a range of conditions such as cancer, diabetes, and mental health.

When billing for these preventive services, healthcare providers must use modifier 33 to indicate that the service was provided at no cost to the patient. This helps the insurance company properly process the claim and ensure that the patient does not receive a bill for the service.

It is important for healthcare providers to keep up to date with the current guidelines and regulations regarding preventive services and the use of modifier 33 to ensure accurate billing and compliance with healthcare laws.