Academic medical centers and teaching hospitals must follow strict Medicare guidelines when billing for services performed by a resident under the supervision of a teaching physician. This is controlled using Modifiers GC and GE.
Modifier GC: Direct Involvement
Use Modifier GC to indicate that the service was performed in part by a resident under the direction of a teaching physician. The teaching physician must be present during the key or critical portions of the service and must personally document their involvement.
Modifier GE: The Primary Care Exception
Use Modifier GE for services performed by a resident without the presence of a teaching physician, under the "Primary Care Exception." This only applies to specific primary care centers where the resident has been in the program for at least 6 months, and the teaching physician is immediately available and reviews the care.
NCCI and Modifier Placements
GC and GE modifiers are informational, but they must be placed accurately on the claim line alongside any pricing modifiers (like 25 or 59). Use our checker to ensure correct modifier stacking.