CPT modifier
Modifier 33: Preventive services
Modifier 33 is a CPT modifier. In plain terms: Marks a service as preventive so the patient's cost sharing can be waived under the Affordable Care Act rules.
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- Modifier
- 33
- Type
- CPT (Level I) modifier, maintained by the AMA
- Plain description
- Marks a service as preventive so the patient's cost sharing can be waived under the Affordable Care Act rules.
- How it is used
- Used when a preventive service code does not already say it is preventive, such as a screening that turns into a procedure.
- Claim form
- CMS-1500 item 24D, up to four modifiers per line. 837P SV101-3 to SV101-6.
The CPT descriptor is AMA copyright and is not shown here. The description above is written by Rivvi. Read the CMS guidance linked above for Medicare's rules.
Related modifiers
Related pages
Questions
What does modifier 33 mean?
Modifier 33 is a CPT modifier. In plain terms: Marks a service as preventive so the patient's cost sharing can be waived under the Affordable Care Act rules.
Is modifier 33 a CPT or a HCPCS modifier?
33 is a CPT (Level I) modifier. The AMA maintains CPT modifiers. Two-character codes with a letter, such as GT or XU, are HCPCS Level II modifiers from CMS.
Where does modifier 33 go on a claim?
On the CMS-1500 it goes in item 24D next to the procedure code. Each line holds up to four modifiers. On an 837P it goes in SV101-3 to SV101-6.
When is modifier 33 used?
Used when a preventive service code does not already say it is preventive, such as a screening that turns into a procedure.
What denial comes back when a modifier is wrong?
A missing or mismatched modifier often comes back as CARC 4. A modifier that was not valid on the date of service comes back as CARC 182. A bundling edit the modifier should have bypassed comes back as CARC 97 or 236.