Fee Navigator

    Complexity modifiers

    Complexity modifiers may only be billed for the time spent on management of the patient's care for the total time spent, providing the time was spent on the same day the patient was seen. For example:

    • Day one - Physician reviews chart, sees patient, completes referral letter on the same day. Total time spent managing patient care: 35 minutes. Therefore, the complexity modifiers CMXV15, CMXV20, CMXV30, CMXV35, CMGP OR CMXC30 as appropriate may be claimed in addition to the visit service.
    • Day one - Physician reviews chart and sees the patient. Total time spent: 25 minutes.
    • Day two - Physician completes referral letter. Total time spent: 10 minutes. The time spent completing the referral letter may not be included in the time spent on day one – the physician may only claim for 25 minutes of time.