CMGP modifier

The complex modifier, CMGP, compensates physicians for a number of activities, not just for time spent face-to-face. The time to calculate the modifier includes the following activities, which must be completed on the same date of service the patient was seen:

  • Writing a referral letter.
  • Charting.
  • Reviewing the chart.
  • Reviewing but not waiting for lab/DI results.
  • Talking with and examining the patient.
  • Anything else the physician does in relation to the patient's care.

The CMGP modifier can only include the physician’s time and not the time of other facility or office staff

The CMGP modifier applies to HSC’s 03.01J, 03.03A, 03.03B, 03.03C, 03.03N, 03.03P, 03.03Q, 03.07A and 03.07B.  The CMGP modifier can also be claimed as appropriate in any location.

CMGP may only be claimed when the full amount of time is expended per unit.  The first unit is claimed when 15 minutes has elapsed, and subsequent units may not be claimed until a full minute has elapsed. 

The following are the time increments for billing CMGP:

  • 0-14 minutes: Visit only.
  • 15-24 minutes: Visit + CMGP01.
  • 25-34 minutes: Visit + CMGP02.
  • 35-44 minutes: Visit + CMGP03.
  • 45-54 minutes: Visit + CMGP04.
  • 55-64 minutes: Visit + CMGP05.
  • 65-74 minutes:  Visit + CMGP06.
  • 75-84 minutes:  Visit + CMGP07.
  • 85-94 minutes:  Visit + CMGP08.
  • 95-104 minutes: Visit + CMGP09.
  • 105 minutes or more: Visit + CMGP10.

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