Physical Status Modifier

Policy Update #: POLPSM061526
Effective Date: June 15, 2026 (Professional); July 15, 2026 (Facility)
Current State: Currently, if modifiers P3, P4 or P5 are appended to an anesthesia procedure code, additional modifying units will be added to the base units, which causes an increase in the reimbursement calculation for anesthesia services.
Future State: Procedures billed with these modifiers will be reimbursed based on the base units of the anesthesia procedure only; no additional reimbursement will be considered for these modifiers.
Applicable Plan(s): Commercial, Medicaid and Medicare
Applicable Policy: Anesthesia Payment Policy
Policy Number: 3835
Business Owner: Payment Policy

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Physical Status Modifier Policy Update