Health Professional Shortage Area (HPSA) and Physician Scarcity Area (PSA) Modifiers

HCPCS Modifier                                          Description 

AQ                                                     Service performed in a Health Professional Shortage Area. This                                                                  modifier is used by physicians to indicate the services reported were                                                               rendered in a qualified Health Professional Shortage Area (HPSA)                                                                 and are eligible for the 10% incentive payment. 

AR                                                        Physician providing services in a physician scarcity area. 

Provider Quality Reporting Initiative (PQRI) Modifiers

These modifiers are only to be used for PQRI, no other modifiers should be used when reporting PQRI.

CPT Modifier                                                      Description  

1P                                            Performance Measure Exclusion Modifier Due to Medical Reasons

2P                                             Performance Measure Exclusion Modifier Due to Patient Choice

3P                                              Performance Measure Exclusion Modifier Due to System Reasons 

8P                                            Performance Measure Reporting Modifier - Action Not Performed, Reason                                                   Not Otherwise Specified 

Ambulance Modifiers 

• For ambulance service claims, institutional-based providers and suppliers must report an origin and destination modifier for each ambulance trip provided in HCPCS/Rates.

 • Origin and destination modifiers used for ambulance services are created by combining two alpha characters. The first position alpha code equals origin; the second position alpha code equals destination. 

Origin/ Destination                                                  Description  

D                                                           Diagnostic or therapeutic site other than P or H                                                        when these are used as origin codes 

E                                                  Residential, domiciliary, custodial facility (other than 1819 facility) 

G                                                                  Hospital based ESRD facility 

H                                                                                  Hospital 

I                               Site of transfer (e.g. airport or helicopter pad) between modes of ambulance transport 

J                                                                    Freestanding ESRD facility 

N                                                                       Skilled nursing facility 

P                                                                         Physician’s office 

R                                                                             Residence 

S                                                                 Scene of accident or acute event 

X                                                     Intermediate stop at physician’s office on way to hospital 

Note: This is a destination code only 

In addition, institutional-based providers must report one of the following modifiers with every HCPCS code to describe whether the service was provided under arrangement or directly. 

HCPCS Modifier                                                                Description

QM                                  Ambulance service provided under arrangement by a provider of services 

QN                                      Ambulance service furnished directly by a provider of services 

QL                                           Patient pronounced dead after ambulance called