Saturday, March 6, 2010

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

HPSAFor claims with dates of services prior to January 1, 2006, these modifiers are 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.
QB Physician providing service in a rural HPSA

QU Physician providing service in an urban HPSA

Effective for dates of service on or after January 1, 2006, a new modifier -AQ replaces the two existing modifiers (QB and QU) for physician services provided in HPSAs. Effective October 1, 2007, claims received for dates of service 01/01/2006 and after with modifiers QB or QU will be rejected/denied.
AQ Service performed in a Health Professional Shortage Area.


PSAIn some cases, a service may be provided in county that is considered to be a PSA, but the ZIP code is not considered to be dominant for that area. The bonus payment cannot automatically be made. In order to receive the bonus for those areas, physicians will need to include the modifier AR.
Physician’s Voluntary Reporting Program
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

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