AK modifer – Rendered in a CAH By a Non-participating physician.

Description Services : Rendered in a CAH By a Non-participating physician.
Required for Claims : Critical Access Hospitals (CAHs) Electing the Optional Payment Method (Method II)
Type of Bill: 85X

Coding Guidelines : Applies to services rendered by a non-participating physician (revenue code 961 or 98X)

General Guidelines : This modifier should be used only for critical access hospitals who elect the Method 2 outpatient payment methodology (All-inclusive rate) when the professional services
are performed by clinical psychologists.

Payment Implications : The CAH will receive 95% of the physician fee schedule times 115% for these
services. (or multiply the fee schedule amount by 1.0925.