Mystery solved: CMS releases new split shared and critical care modifiers

by: Julia Kyles, CPC Nov 9, 2021

If you’ve been following the split (or shared) and critical care saga, you know that Medicare announced in the final 2022 Medicare physician fee schedule that it would require new modifiers with the services.

According to the final rule, one modifier will be added to claims for split or shared encounters in the facility setting, while another will be added to critical care services (99291-99292) that are performed during the global surgical period or on the same day as another E/M visit reported by the same physician.

However, the modifiers themselves were not in the final rule, which created a mystery around when the new modifiers would be released and what they would look like. That mystery ended with the Nov. 8 release of the 2022 HCPCS code set. The two modifiers are:

FS (Split [or shared] evaluation and management visit).
FT (Unrelated evaluation and management [E/M] visit during a postoperative period, or on the same day as a procedure or another E/M visit. [Report when an E/M visit is furnished within the global period but is unrelated, or when one or more additional E/M visits furnished on the same day are unrelated]).

Modifier FS will be used with claims for split (shared) visits performed in facility settings and split (or shared) critical care visits. Practices should not add the modifier to office or other outpatient visits (99202-99215).

The descriptor for modifier FT indicates that it should be reported with critical care visits when appropriate based on guidance on the final rule, even though the descriptor seems to apply to any E/M visit. Stay tuned for additional guidance in the coming days.

Blog Tags: CMS, E/M services, fee schedule

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