Not using the modifier shouldn't result in a higher reimbursement. (Of course I must tell you I am an extremely optimistic person who lives in a very happy world.
) If they require the modifier they should deny the claim without it. The reimbursement should be based on the rendering provider's NPI number and how Medicare has them credentialed. I certainly would hope it would work that way or else it could get quite messy. I know the fee schedule for the psychologist is higher than a social worker but I hope there is more to the system than relying on the modifier.
Can you imagine the mess if they paid higher, then went back to request the overpayment? Ughhh.
Anyway, since I don't bill in any regions that require the AJ modifier I am not sure. But I appreciate the link, it really has some great info!
Michele