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Modifier Q5

Surgical / provider-role

Modifier Q5. Substitute physician under a reciprocal billing arrangement.

Reference only — CPT descriptors are AMA-copyrighted (paraphrased). Payment percentages and acceptance vary by payer; verify against the current CPT/HCPCS files and payer policy.

Related modifiers

AS
PA, NP, or CNS as assistant at surgery — must accompany 80/81/82. Medicare pays …
GC
Service partly performed by a resident under a teaching physician (present for k…
GE
Resident service under the primary care exception (no teaching physician present…
FS
Split/shared E/M visit (facility settings) — bill under the NPI of the practitio…
FT
Unrelated E/M during a postoperative period or same day as another procedure (es…
Q6
Substitute physician under a fee-for-time ('locum tenens') arrangement — 60-day …

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