The HN modifier, like the HO modifier, is a HCPCS modifier used in coding some claims. These modifiers are different from CPT or procedure codes and are used to describe something else about the claim. One commonly used example is the HJ modifier which is usually used to code Employee Assistance Program (EAP) visits. Modifiers are normally used in addition to the CPT codes to fully describe the service.
What does HN Signify?
The HN signifies that the highest degree the provider currently has is a bachelor’s degree. Similar codes HO signifies a masters degree and HP a doctoral degree level. Not sure if you need to file with HN? This is where a billing service such as TheraThink can help to determine by calling the insurance company and asking.
Since being a licensed therapist requires a master’s degree HN is rarely used. It may be applicable in some cases where there is an intern seeing a client under the supervision of another provider.
Who Requires the HN Modifier?
Most insurance companies do not require a HCPCS modifier. The vast majority of private insurance plans and Medicare do not require the use of a degree-signifying HCPCS code like HN. So who does require it?
Some, but not all Medicaid plans require the use of a degree modifier. It is important to know when this is relevant. These companies will usually deny the claim completely if the appropriate modifier is not applied to the claim. A service like TheraThink can call ahead to make sure it is being properly billed.
HN is also notably different than AJ and AF, two other modifiers that are sometimes required by specific Medicaid plans.
What CPT Code Do I use With This Modifier?
Most typically this is billed with standard mental health procedure codes like 90791, 90834, or 90837.
How Do I Bill the HN Modifier on a CMS 1500 Form?
Like other HCPCS, the HN modifier should be used under the 24d field on the CMS 1500, with the CPT code in 24c.