ARSD 67:16:25:12.05. Claim requirements -- Modifier codes -- Ambulance, secure medical, and community transportation services

A modifier code provides the means by which the reporting provider indicates on the claim form that a service that was provided was altered by some specific circumstance but not changed in its definition or code. When applicable, the following codes must be included on a provider's claim for ambulance, secure medical, or community transportation services: Modifier Description TK Extra patient TN Rural/outside the provider's customary service area QM Hospital arranged secure medical transfer.