{"id":10042,"date":"2019-11-20T15:39:40","date_gmt":"2019-11-20T10:09:40","guid":{"rendered":"https:\/\/www.medicalbillersandcoders.com\/blog\/?p=10042"},"modified":"2026-05-11T11:15:42","modified_gmt":"2026-05-11T11:15:42","slug":"reimbursement-guidelines-for-modifiers-90","status":"publish","type":"post","link":"https:\/\/www.medicalbillersandcoders.com\/blog\/reimbursement-guidelines-for-modifiers-90\/","title":{"rendered":"Reimbursement Guidelines for Modifier 90"},"content":{"rendered":"

Reference (Outside) Laboratory:<\/strong> When laboratory procedures are performed by a party other than the treating or reporting physician, the procedure may be identified by adding Modifier 90 to the usual procedure number. For the Medicare<\/a> program, this modifier is used by independent clinical laboratories when referring tests to a reference laboratory for analysis.<\/p>\n

Modifier 90 is used by a physician or clinic when the laboratory tests performed for a patient are performed by an outside or reference laboratory. This modifier is used to indicate that although the physician is reporting the performance of a laboratory test, the actual testing component was a service from a laboratory.<\/p>\n

Modifier 90 is used when laboratory procedures are performed by a party other than the treating or reporting physician and the laboratory bills the physician for the service. For example, the physician (in his office) orders a CBC, the physician draws the blood and sends the specimen to an outside laboratory. When outside reference laboratory services are billed using modifier 90:<\/p>\n