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Modifier 76

Modifier 76 Description and Billing Use

Plain-language description

Reports a medically necessary repeat service by the same physician or qualified professional when supported.

How modifier 76 is used

Modifier 76 identifies a medically necessary repeat procedure or service performed by the same physician or qualified professional. It is not interchangeable with modifier 77 and does not replace documentation of why repetition was necessary.

Compare modifier 77 before billing a repeat service.

Before reporting this modifier

  1. 1. Confirm the current official or licensed definition and payer acceptance.
  2. 2. Identify the exact claim circumstance the modifier communicates.
  3. 3. Make the code, setting, related services, and medical record consistent.
  4. 4. Check NCCI, global surgery, component, DME, ABN, or drug rules that apply.
  5. 5. Do not append a modifier only to force an edit override.
LessonStudy the related billing ruleOfficial sourceReview current CMS guidance

This is a workflow summary, not a licensed CPT definition or claim-specific coding instruction. Verify the code set and payer rule effective for the date of service.