Modifier 59: Distinct procedural service

Modifier Code

Code Type

Billing modifier

When to Use Modifier 59

Append modifier 59 when a procedure or service is distinct from another service billed on the same day, and would otherwise be considered bundled or excluded from separate payment. In therapy, this is most often used when a second, distinct CPT code is medically necessary on the same date. Many payers now prefer the more specific X{EPSU} modifiers (XE, XP, XS, XU) over 59.

CPT Codes Commonly Paired with Modifier 59

These CPT codes are frequently billed alongside modifier 59 in therapy practice:

CPT 90837 - Psychotherapy, 60 minutes CPT 90834 - Psychotherapy, 45 minutes CPT 90846 - Family psychotherapy without patient present CPT 96130 - Psychological testing evaluation, first hour CPT 90791 - Psychiatric diagnostic evaluation

Superbill Notes for Modifier 59

What to include: Document why each service was medically necessary and clinically distinct. Include session notes that specify the separate clinical rationale for each procedure billed on the superbill.

Adding Modifier 59 to a Superbill

Superbilled lets you add modifier codes directly to each line item on your superbill. When generating a superbill with modifier 59, make sure to include your NPI number, the patient's diagnosis code, date of service, fee charged, and amount paid. The modifier appears alongside the CPT code on the claim.

Generate a superbill with Modifier 59 free