Getting paid: Modifier 25 payment cuts to take effect; doctor opposition continues

Why This Topic Matters

The topic is important because it may affect reimbursement, scheduling, contract strategy, and payer relations for practices that frequently bill same-day evaluation and management services with procedures. It also signals a possible broader payer trend that could influence future payment policy decisions.

Article Sections

1. Policy change and affected markets

   Summarizes the planned payer policy change, the timing of implementation, and the geographic areas and plan types that may be affected.

2. Provider and specialty response

   Describes reactions from physicians, medical societies, and specialty organizations, including concerns raised about payment policy and patient care.

3. Trend concerns and broader payer context

   Discusses earlier payer actions, reactions from the provider community, and concerns that similar policies could spread.

4. What you can do

   Outlines practice-level considerations for organizations that may be impacted and suggests reviewing payer relationships and contracts.