According to a notice from the Illinois Dept.
CPT Category II codes are tracking codes which facilitate data collection for the purposes of performance measurement. The tracking codes are adopted and reviewed by the Performance Measures Advisory Group (PMAG). The PMAG is made up of experts in performance measurement from organizations including the AMA, NCQA, CMS, AHRQ and JCAHO.
Effective June 22, 2015, Humana will make the following modifier changes to professional claims for their commercial fully insured (including HMOx and select self-funded members), Medicaid and Medicare Advantage HMO, PPO, and private fee-for-service members. However, not all of these products will necessarily be affected by each of the payment policies or modifier updates.
Effective June 1, 2015, BCBSNJ will make changes to their reimbursement policies for modifiers 52, 53, 54, 55, 56, and 73. The purpose of this policy is to provide guidelines for the reimbursement of eligible services appropriately appended with modifiers for participating and non-participating professional providers.