X5 HCPCS Level II modifier: Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another…
X5 is a HCPCS Level II modifier: “Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services….” It adds this detail to the code it is reported with.
Official description
X5Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician
Short description: Svc req by another clinician
HCPCS · United States
Medicare details
The indicators CMS publishes with X5 in its October 2026 file. They describe Medicare’s handling, not another payer’s.
- Medicare coverage
- Carrier judgment
- Added
- Jan 1, 2018
Where X5 sits
- 1GroupHCPCS modifiers
- 2Modifier X5Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician
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 X5 mean?
X5 is the HCPCS code for “Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician” in CMS’s HCPCS Level II October 2026 release.
Where is X5 in the HCPCS Level II list?
X5 is listed under Modifiers.
Does Medicare cover X5?
CMS lists X5’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 X5
All modifiersVMMedicare diabetes prevention program (mdpp) virtual make-up sessionVPAphakic patientX1Continuous/broad services: for reporting services by clinicians, who provide the principal care for a patient, with no planned endpoint of the relationship; services in this…X2Continuous/focused services: for reporting services by clinicians whose expertise is needed for the ongoing management of a chronic disease or a condition that needs to be…X3Episodic/broad services: for reporting services by clinicians who have broad responsibility for the comprehensive needs of the patient that is limited to a defined period and…X4Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the…XESeparate encounter, a service that is distinct because it occurred during a separate encounterXPSeparate practitioner, a service that is distinct because it was performed by a different practitionerXSSeparate structure, a service that is distinct because it was performed on a separate organ/structureXUUnusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main serviceZANovartis/sandozZBPfizer/hospira