CPT modifier used for multiple outpatient hospital E/M encounters on the same date. For hospital outpatient reporting purposes, utilization of hospital resources related to separate and distinct E/M encounters performed in multiple outpatient hospital settings on the same date may be reported by adding the modifier -27 to each appropriate level outpatient and/or emergency department E/M code(s). This modifier provides a means of reporting circumstances involving E/M services provided by physician(s) in more than one (multiple) outpatient hospital setting(s) (e.g., hospital emergency department, clinic). Do not use this modifier for physician reporting of multiple E/M services performed by the same physician on the same date. See evaluation and management (E/M) codes, emergency department , or preventive medicine codes .