Reduced Procedure ... Reduced Fees

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The Double Fee Schedule

Cash Discounts... How to do them how to bill them


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CPT Modifier -52 means Reduced Services. NOT reduced price


If you deliver a significantly reduced procedure, you MUST bill it with -52.
If you deliver a complete and full procedure as described in CPT, you MUST NOT use -52

It is the doctor's duty (not an insurance company's) to formulate a balanced fee schedule, If it's ethically appropriate to reduce fees for reduced procedures, you certainly may do so.

There is confusion that some think -52 means "reduced fee" instead of "reduced service" and use it when applying a payment discount for full services, which is completely incorrect. It's not that you can't reduce fee when using -52 ... you certainly can... it's that you don't use -52 when simply reducing fees.


There is, to complicate matters, a warning in CCI edits about fewer than 7 minutes of time code service being unbillable. It might be combined into other services, but that is more complex... thus this article in the works.