QJ HCPCS Level II modifier: Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42…
QJ is a HCPCS Level II modifier: “Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b).” It adds this detail to the code it is reported with.
Official description
QJServices/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b)
Short description: Patient in state/locl custod
HCPCS · United States
Notes for QJ
As CMS prints them, with any note QJ takes from the headings above it.
Note
- CMS processing note 0111: IN ACCORDANCE WITH 42 CFR 411.4 (B).
Medicare details
The indicators CMS publishes with QJ in its October 2026 file. They describe Medicare’s handling, not another payer’s.
- Medicare coverage
- Special coverage instructions apply
- Added
- Jan 1, 2003
Where QJ sits
- 1GroupHCPCS modifiers
- 2Modifier QJServices/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b)
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 QJ mean?
QJ is the HCPCS code for “Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b)” in CMS’s HCPCS Level II October 2026 release.
Where is QJ in the HCPCS Level II list?
QJ is listed under Modifiers.
Does Medicare cover QJ?
CMS lists QJ’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 QJ
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