I code physician services for a hospital that has an internal medicine and surgical residency program, the company I work for was instructed by hospital administration not to use the GC modifier with the logic that the hospital has an outpatient clinic GME program therefore all In patient services are exempt from reporting the GC modifier. My understanding is that any service done by a resident under supervision needs the GC modifier and GME programs only cover low level outpatient EM’s when done by a resident without direct supervision but still require modifier GE. Guidelines from CMS have been presented to the hospital administrator and she is admit that reporting supervised resident services with GC modifier is incorrect, that no modifier is needed can anyone advise?