Modifier SA: Nurse practitioner rendering service in collaboration with physician

Modifier Code

Code Type

Billing modifier

When to Use Modifier SA

Append modifier SA when a nurse practitioner (NP) is the rendering provider and the service is performed in collaboration with or under the supervision of a physician. This modifier is used in integrated behavioral health settings where an NP provides therapy or psychiatric services alongside a supervising physician. State scope-of-practice laws and payer-specific rules govern when collaboration is required.

CPT Codes Commonly Paired with Modifier SA

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

CPT 90837 - Psychotherapy, 60 minutes CPT 90791 - Psychiatric diagnostic evaluation CPT 99213 - Office or outpatient visit, moderate complexity CPT 99214 - Office or outpatient visit, high complexity CPT 90833 - Psychotherapy add-on, 30 minutes with E/M

Superbill Notes for Modifier SA

What to include: Include the NP's NPI and the supervising physician's NPI on the superbill. Document the collaborative or supervisory arrangement and confirm that this arrangement satisfies both state law and payer credentialing requirements.

Adding Modifier SA to a Superbill

Superbilled lets you add modifier codes directly to each line item on your superbill. When generating a superbill with modifier SA, 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 SA free