CA HCPCS Level II modifier: Procedure payable only in the inpatient setting when performed emergently on an outpatient who expires prior to admission
CA is a HCPCS Level II modifier: “Procedure payable only in the inpatient setting when performed emergently on an outpatient who expires prior to admission.” It adds this detail to the code it is reported with.
Official description
CAProcedure payable only in the inpatient setting when performed emergently on an outpatient who expires prior to admission
Short description: Procedure payable inpatient
HCPCS · United States
Medicare details
The indicators CMS publishes with CA in its October 2026 file. They describe Medicare’s handling, not another payer’s.
- Medicare coverage
- Carrier judgment
- Added
- Jan 1, 2003
Where CA sits
- 1GroupHCPCS modifiers
- 2Modifier CAProcedure payable only in the inpatient setting when performed emergently on an outpatient who expires prior to admission
Source and release
- Data release
- HCPCS Level II · October 2026
- Effective date
- Oct 1, 2026
- Publisher
- CMS
This page is built from the HCPCS Level II catalog that Vero Codes reads when it suggests codes: Centers for Medicare & Medicaid Services’s October 2026 release, imported from the publisher’s file and checked against it. The description, notes and structured data come from the same record.
Frequently asked questions
What does HCPCS code CA mean?
CA is the HCPCS code for “Procedure payable only in the inpatient setting when performed emergently on an outpatient who expires prior to admission” in CMS’s HCPCS Level II October 2026 release.
Where is CA in the HCPCS Level II list?
CA is listed under Modifiers.
Does Medicare cover CA?
CMS lists CA’s Medicare coverage as “Carrier judgment”. Coverage and payment still depend on the patient, the setting, the documentation and the payer.
Which HCPCS Level II release does this page use?
It uses CMS’s October 2026 release, in effect from Oct 1, 2026 to Dec 31, 2026. It is a reference: confirm the code against the current list and the payer’s rules before you submit it.
Codes beside CA
All modifiersBAItem furnished in conjunction with parenteral enteral nutrition (pen) servicesBLSpecial acquisition of blood and blood productsBOOrally administered nutrition, not by feeding tubeBPThe beneficiary has been informed of the purchase and rental options and has elected to purchase the itemBRThe beneficiary has been informed of the purchase and rental options and has elected to rent the itemBUThe beneficiary has been informed of the purchase and rental options and after 30 days has not informed the supplier of his/her decisionCBService ordered by a renal dialysis facility (rdf) physician as part of the esrd beneficiary's dialysis benefit, is not part of the composite rate, and is separately reimbursableCCProcedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)CDAmcc test has been ordered by an esrd facility or mcp physician that is part of the composite rate and is not separately billableCEAmcc test has been ordered by an esrd facility or mcp physician that is a composite rate test but is beyond the normal frequency covered under the rate and is separately…CFAmcc test has been ordered by an esrd facility or mcp physician that is not part of the composite rate and is separately billableCGPolicy criteria applied