Benchmark of the Week: Established E/M with mod. 25 denial rates by POS

Article Overview

This article summarizes a Medicare claims analysis focused on denial rates for established patient evaluation and management services reported with modifier 25, compared by place of service. It is useful for coders, billing staff, compliance teams, and revenue cycle professionals who want a high-level view of how denial patterns differ across outpatient, office, inpatient, and emergency room settings. The article also provides general benchmarking context and commentary on why these claims may be denied more or less often in different settings.