The Transfer of Care (TOC) modifier is applied to claims for hospital daily care (03.03D) on the date of service that the patient is being transferred. Both the receiving physician and the transferring physician may submit claims for the same patient on the date of transfer. However the TOC modifier is only added to 03.03D claims by the physician who is taking over the care.
The TOC modifier demonstrates the need for two 03.03D claims on the same date of service (03.03D is not billable for routine post-operative care within the inclusive-care period of the procedure.)
Specialists such as internal medicine have their own TOC codes and should continue to use the TOC codes that are applicable to their specialty.
If the transferring physician does not submit a 03.03D on the day of transfer, the receiving physician does not need to add the TOC modifier.
For more information, see the Online billing advice website section (log in required).
For more advice from AMA staff on any billing issues, including explanations of recent billing changes, please email AMA billing staff.
