HCPCS Level II modifier
Modifier KX
Modifier KX is a HCPCS Level II modifier. CMS describes it as: Requirements specified in the medical policy have been met.
Source: CMS HCPCS Level II, October 2026 file dated September 23, 2026. Publisher page
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- Modifier
- KX
- Type
- HCPCS Level II modifier, maintained by CMS
- CMS description
- Requirements specified in the medical policy have been met
- Claim form
- CMS-1500 item 24D, up to four modifiers per line. 837P SV101-3 to SV101-6.
- Guidance
- CMS HCPCS quarterly update
Liability notices and coverage
- GAWaiver of liability statement issued as required by payer policy, individual case
- GXNotice of liability issued, voluntary under payer policy
- GYItem or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
- GZItem or service expected to be denied as not reasonable and necessary
Therapy plans of care
- GPServices delivered under an outpatient physical therapy plan of care
- GOServices delivered under an outpatient occupational therapy plan of care
- GNServices delivered under an outpatient speech language pathology plan of care
- CQOutpatient physical therapy services furnished in whole or in part by a physical therapist assistant
- COOutpatient occupational therapy services furnished in whole or in part by an occupational therapy assistant
- 96Habilitative services
- 97Rehabilitative services
Related modifiers
- GAWaiver of liability statement issued as required by payer policy, individual case
- GXNotice of liability issued, voluntary under payer policy
- GYItem or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
- GZItem or service expected to be denied as not reasonable and necessary
- GPServices delivered under an outpatient physical therapy plan of care
- GOServices delivered under an outpatient occupational therapy plan of care
- GNServices delivered under an outpatient speech language pathology plan of care
- CQOutpatient physical therapy services furnished in whole or in part by a physical therapist assistant
- COOutpatient occupational therapy services furnished in whole or in part by an occupational therapy assistant
- 96Habilitative services
- 97Rehabilitative services
Related pages
- All CPT and HCPCS modifiersA to Z list
- CMS-1500 claim formModifiers go in item 24D
- Denial code CO-4Modifier missing or does not fit the code
- Denial code CO-182Modifier invalid on the date of service
- Denial code CO-50Not medically necessary
- Denial code CO-96Non-covered charge
- HCPCS Level II code lookup
- Denial and remark codes
Questions
What does modifier KX mean?
Modifier KX is a HCPCS Level II modifier. CMS describes it as: Requirements specified in the medical policy have been met.
Is modifier KX a CPT or a HCPCS modifier?
KX 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 KX 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.