November 16, 2020
Billing Reminder GW Modifier
If the beneficiary is currently enrolled in hospice and the need for the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) item provided is not related to their hospice condition, the GW modifier must be appended to the applicable HCPCS codes.
GW - Service not related to the hospice patient's terminal condition
Effective for claims submitted on or after December 1, 2020, with dates of service on or after September 7, 2020, with the above scenario, without the GW modifier, will be denied. These claims can be corrected through myCGS or resubmitted with the GW modifier.
If more than four modifiers are required to be appended to the same HCPCS code, replace the fourth modifier with modifier 99 and add the overflow modifiers to Item 19 of the CMS-1500 claim form or its electronic equivalent.