Using Modifier 52 on a CPT Code
When a provider is billing the Medicare program for a reduced service, they are to append modifier-52 to that CPT code on the claim form. When billing for a reduced service, providers should reduce the billed amount by 50% just as providers are to increase a bilateral billing by 50%. Maintaining the same charge for a reduced service is not proper billing. Please make sure that when you submit any CPT code with modifier-52, that you are also reducing the billed amount by 50% prior to submission of the claim to your Medicare contractor. Two examples of when a provider