Q5 HCPCS Level II modifier: Service furnished under a reciprocal billing arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical…
Q5 is a HCPCS Level II modifier: “Service furnished under a reciprocal billing arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional….” It adds this detail to the code it is reported with.
Official description
Q5Service furnished under a reciprocal billing arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
Short description: Recip bill arr subs md or pt
HCPCS · United States
Medicare details
The indicators CMS publishes with Q5 in its October 2026 file. They describe Medicare’s handling, not another payer’s.
- Medicare coverage
- Special coverage instructions apply
- Added
- Jan 1, 1993
Where Q5 sits
- 1GroupHCPCS modifiers
- 2Modifier Q5Service furnished under a reciprocal billing arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
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 Q5 mean?
Q5 is the HCPCS code for “Service furnished under a reciprocal billing arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area” in CMS’s HCPCS Level II October 2026 release.
Where is Q5 in the HCPCS Level II list?
Q5 is listed under Modifiers.
Does Medicare cover Q5?
CMS lists Q5’s Medicare coverage as “Special coverage instructions apply”. 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 Q5
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