decisionhealth Newsletters, Part B News - 2025 Issue 10 (October)
Denials on most-billed modifier 25 claims are up across the board
Subscribe or sign in to view the full article.
Article Overview
This article examines recent Medicare claims data on same-day evaluation and management billing with modifier 25. It focuses on which services are most commonly billed, how denial rates changed year over year, and why the trends matter for practices that submit high-volume E/M claims. The piece is aimed at coders, billers, compliance staff, and revenue cycle teams tracking E/M claim performance.
Why This Topic Matters
Understanding shifts in denial rates for high-volume E/M claims helps practices monitor billing risk, compare performance over time, and identify areas where claims scrutiny may be increasing.
What You Will Learn
- Which categories of E/M services are most commonly billed with modifier 25
- How denial rates and payments changed for high-volume modifier 25 claims over time
- Which broad service types appear among the most-billed claims in the article's Medicare analysis
- How to interpret utilization and denial trend reporting for same-day E/M billing
Who Should Read This
- Medical coders
- Medical billers
- Revenue cycle managers
- Compliance professionals
- Practice administrators
- Physician billing staff
Codes Discussed
Modifiers Discussed
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com