Optimizing Orthopaedic Care: A Guide to Global-Period and Transfer-of-Care Modifiers

Christine Banks, RHIA, CPC, CPCO
Karen Zupko and Associates, Inc.

In the May 2025 AAOS Now practice management article, “Optimizing Orthopaedic Care: A Guide to Global-Period and Transfer-of-Care Modifiers,” Christine Banks, RHIA, CPC, CPCO, reviews the structure of the global surgical period and the importance of accurate documentation and coding to support continuity of care and proper reimbursement. The article explains how preoperative, intraoperative, and postoperative services are bundled within 0-, 10-, or 90-day global periods and how relative value units are distributed across each phase of care.

The article highlights expanded CMS documentation requirements in 2025 for cases in which postoperative care is transferred to another provider outside of the operating surgeon’s group practice. It provides detailed guidance on appropriate use of modifiers 54 (surgical care only), 55 (postoperative management only), and 56 (preoperative management only), as well as when evaluation and management services should be reported instead. The article also introduces HCPCS code G0559, which may be reported once per 90-day global period to capture postoperative follow-up work when no formal transfer of care has occurred.

This article offers practical insight for orthopaedic practices navigating global-period billing and transfer-of-care scenarios and reinforces the need for clear communication, proper documentation, and adherence to updated CMS guidelines to reduce compliance risk and support optimal patient outcomes.

Read the full article on AAOS Now: