How to Use an EP Modifier

Medical facilities who give early preventive screenings and treatments to children and young adults from the age of birth to 21 must bill Medicaid service providers to receive payment for health services. The billing department uses form CMS-1500, previously HCFA-1500, for insurance billing. The form must contain the current procedural terminology (CPT) code to represent the type of medical service given along with an EP modifier to show this was an early preventative service office visit. Types of early preventative health care include immunization administration and health screenings for hearing and vision problems.

Things You'll Need

• CMS 1500 health insurance claim form

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Instructions

• 1

  Prepare the CMS-1500 form to bill Medicaid. Have the patient or insurer of the patient fill out the required sections of the CMS-1500 form with the patient's personal information and insurance carrier.

• 2

  Complete the physician section of the form. Place in the proper CPT code under box 24D for procedures, services and supplies. The CPT code represents the preventive injected vaccine or health screening assessment. Write the number code in the spaces under the heading, "CPT/HCPCS."

• 3

  Fill in the column under 24D modifier with the EP modifier code. Complete the form by filling in the total charges for services. Send the form to the Medicaid insurance provider for reimbursement.