Use of modifier -25 for a separate E/M service is OK

Article Overview

This premium article covers HCFA’s proposed physician fee schedule guidance on same-day billing of an evaluation and management service when a separate procedure is also performed. It is aimed at coders, billers, compliance staff, and physician practices that need to understand the general policy context, the role of the global period, and the examples used to clarify when modifier -25 is appropriate. The discussion also references how the proposal aligns with CPT guidance and how it may affect denials and reimbursement processing.