decisionhealth Newsletters, Part B News - 2018 Issue 3 (March)
Update: Anthem rescinds decision to cut modifier 25-related payments
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Article Overview
This article reports on Anthem’s decision to withdraw a planned policy change affecting same-day professional services tied to modifier 25. It summarizes the reaction from physician groups and medical societies, and it notes that Anthem may still pursue other cost-control approaches. The piece is relevant to physicians, coders, compliance teams, and revenue cycle staff tracking payer policy changes and specialty society advocacy.
Why This Topic Matters
Payer policy changes can affect professional claims processing, physician reimbursement, and documentation review workflows. This update helps readers monitor insurer payment actions and the responses from major medical organizations.
What You Will Learn
- The scope of the payer policy change discussed in the update
- Which medical organizations and specialty groups responded to the proposed policy
- How the insurer described its revised position and future cost-control direction
- Why this payer action matters for professional billing and claims management
Who Should Read This
- Physicians
- Medical coders
- Billing staff
- Revenue cycle professionals
- Compliance teams
- Practice administrators
- Medical specialty societies
Modifiers Discussed
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