HCPCS Level II modifier
Modifier CI
Modifier CI is a HCPCS Level II modifier. CMS describes it as: At least 1 percent but less than 20 percent impaired, limited or restricted.
Source: CMS HCPCS Level II, October 2026 file dated September 23, 2026. Publisher page
Run it in Rivvi
Check the codes on your claims export
Upload a claims export. Rivvi flags ICD-10 and HCPCS codes that are not billable or are replaced. It does not check modifiers.
Check my exportFree to start. Opens Rivvi, the AI workspace for healthcare teams.
- Modifier
- CI
- Type
- HCPCS Level II modifier, maintained by CMS
- CMS description
- At least 1 percent but less than 20 percent impaired, limited or restricted
- Claim form
- CMS-1500 item 24D, up to four modifiers per line. 837P SV101-3 to SV101-6.
- Guidance
- CMS HCPCS quarterly update
Related modifiers
- CJAt least 20 percent but less than 40 percent impaired, limited or restricted
- CH0 percent impaired, limited or restricted
- CKAt least 40 percent but less than 60 percent impaired, limited or restricted
- CGPolicy criteria applied
- CLAt least 60 percent but less than 80 percent impaired, limited or restricted
- CFAMCC test has been ordered by an ESRD facility or MCP physician that is not part of the composite rate and is separately billable
- CMAt least 80 percent but less than 100 percent impaired, limited or restricted
- CEAMCC test has been ordered by an ESRD facility or MCP physician that is a composite rate test but is beyond the normal frequency covered under the rate and is separately reimbursable based on medical necessity
Related pages
Questions
What does modifier CI mean?
Modifier CI is a HCPCS Level II modifier. CMS describes it as: At least 1 percent but less than 20 percent impaired, limited or restricted.
Is modifier CI a CPT or a HCPCS modifier?
CI is a HCPCS Level II modifier from the CMS quarterly HCPCS file. Two-digit numeric modifiers, such as 25 or 59, are CPT modifiers.
Where does modifier CI 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.
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.