AI: Principal physician of record modifier

For Medicare only

The AI modifier represents the physician who provides an initial visit to a member during an inpatient stay. Physicians reporting modifier “AI” will identify themselves as the physician who will oversee the member’s care from all other physicians furnishing specialty care. Priority Health will align with the CMS guidance.

When to use modifier AI:

  • Admitting physician appends to the initial inpatient hospital care evaluation and management service (99221-99223)
  • Append after payment modifiers
  • Claim may deny when modifier "AI" is not used