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January 5, 2021

CARES Act Claim Adjustment Reopenings for Addition of KE Modifier

The KE modifier can be added to certain accessories used with a non-competitive bid base for dates of service March 6, 2020 through April 22, 2020 in non-rural areas. For example, an E0950 (wheelchair accessory, tray) used with a K0001 (manual wheelchair ) outside a competitive bidding area would be appropriate to add a KE modifier. However, an E0950 (wheelchair accessory, tray) used with a K0823 (Power wheelchair, Group II Standard) outside a competitive bidding area would not be appropriate to add a KE modifier.

Due to the complexity of the KE modifier usage, CGS developed a tool to help identify the appropriate HCPCS to which the KE modifier would apply. We encourage all suppliers to utilize the KE/KY Modifier Tool to confirm if the KE modifier is applicable, prior to submitting your reopening request. The tool offers a search feature as well as a downloadable spreadsheet of HCPCS codes. If a HCPCS base code and accessory combination is not included in this tool, the KE modifier cannot be added and the reopening request will be dismissed.

Please use the Reopening Request FormPDF and Multiple Claim Beneficiary FormPDF for submission of your requests. Additional information and instruction on submission of KE Modifier CURES Act adjustments can be located in the following article: Adding the KE Modifier: Instructions for Reopening a Claim Adjusted Under the CARES Act

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