The Centers for Medicare & Medicaid Services (CMS) and the Office of Inspector General (OIG) have reviewed the use of Modifier 25 to unbundle payments for evaluation and management (E/M) services when ...

August 21, 2018, 01:30 pm News Staff – The AAFP is once again in discussion with a private health insurance company about a payment policy that involves evaluation and management (E/M) codes appended ...

Many codes bundle with evaluation and management (E/M) services using modifier 25, but payers often indicate that codes that include modifier 25 are potentially abusive. (Read about Cigna's recent ...

The American Medical Association (AMA) and more than 100 other provider trade associations have taken issue with a new policy from The Cigna Group regarding claims with modifier 25. Cigna recently ...

CHICAGO, April 17, 2026--(BUSINESS WIRE)--The postponement of Blue Cross Blue Shield of Michigan's (BCBSM) proposed reimbursement policy affecting evaluation and management (E/M) services billed with ...

Medicare payment rules normally do not permit additional payments to physicians for evaluation and management (E/M) services performed on the same day as a therapeutic procedure. However, if the E/M ...

In the news release, Private Practices Would Bear 80% of the Nearly $1B Impact of CMS's Modifier 25 Proposal, issued 24-Sep-2026 by Jiro Health over PR Newswire, we are advised by the company that ...

Current procedural terminology modifiers 25 and 57 may be confusing to some coders, but each serves a specific purpose, according to an AAPC report. For an evaluation and management visit when a ...

Several commercial payers have adopted stricter reimbursement policies to deny modifier -25 claims upfront, according to Joette Derricks, a healthcare compliance and revenue integrity consultant who ...

Jiro's analysis of Medicare claims finds the impact concentrated in six specialties, with dermatology alone accounting for nearly $400 million. AUSTIN, Texas, Sept. 24, 2026 /PRNewswire/ -- A new ...