HCPCS Modifier AB

Description 
Audiology service furnished personally by an audiologist without a physician/NPP order for non-acute hearing assessment unrelated to disequilibrium, or hearing aids, or examinations for the purpose of prescribing, fitting, or changing hearing aids; service may be performed once every 12 months, per beneficiary.

Guidelines and Instructions
The AB modifier can only be billed by a specialty 64 provider (Audiologist) and can only be submitted with 36 audiology procedure codes listed below. 

Non-Covered Information

• If the AB modifier is billed by a provider other than an audiologist, the service will deny.
• If the AB modifier is submitted with a CPT code other than the list above, the service will reject. 
• If the AB and TC or 26 modifiers are submitted incorrectly with a code from the list, the service will reject.
• If the appropriate code/modifier combination are billed more than once within a 12-month period, the service will deny.

Reference: MLN Matters Number: MM13055 (PDF).