Proposal would halve Medicare payments for some same-day services ...

For the second year in a row, health insurer Cigna has delayed a proposal to require more documentation for modifier 25 amid opposition from the American Academy of Family Physicians (AAFP) and other ...

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 ...

A new analysis from Jiro Health estimates that a proposed change to Medicare payments involving Modifier 25 would reallocate approximately $889 million in annual Medicare fee-for-service payments, ...

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 ...

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 ...

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 ...