5 Feb 2016


The modifier "AI" (Principal Physician)

Modifier AI is used with the initial inpatient hospital visit codes (99221-99223) as well as initial nursing facility codes (99304-99306). Effective from 1st Jan 2010.


Modifier AI must be submitted by the admitting physician for the initial hospital care or initial nursing facility care.


As per CMS: To identify the admitting or attending physician who oversees the patient's care while in an inpatient or nursing facility setting


This is an informational modifier. Hence append any payment modifier if applicable before the AI modifier


Note: Effective Jan 1st 2010 Medicare will no longer recognize AMA CPT Consultation codes (Outpatient 99241- 99245 & Inpatient 99251 – 99255). Instead of using consultation codes, we have to use appropriate office or inpatient E&M as alternate codes for the service rendered.


When 2 physicians providing care to a patient on the same day in inpatient hospital settings, eg: Provider “A” who is the admitting physician and Provider “B” is doing consultation on the same day. 

As per Medicare guidelines we have to code initial hospital visit (99221-99223) codes instead of inpatient consultation codes, Since Medicare, don’t pay for consultation codes. In this scenario, we have to bill 2 initial hospital visit codes and we have to append modifier "AI" to the admitting physician.