BCBSM cancels modifier 25 payment adjustment for evaluation and management services
As MSMS previously reported, BCBSM was changing the payment policy when evaluation and management services are billed with office surgical procedures.
In the April 2018 Record, BCBSM announced that evaluation and management services billed with modifier 25 would pay at 80 percent when billed with a surgery on the same day by the same provider, effective July 1, 2018. However, due to MSMS's advocacy efforts and the tangible evidence proving there was no overlap in services when an E&M is billed with office procedures, BCBSM has cancelled the implementation of the policy.
"This is a tangible benefit for MSMS members," said MSMS President Betty S. Chu, MD, MBA, "Without MSMS at the table representing Michigan physicians, we would've lost more than $2 million in care services. I strongly urge all Michigan physicians to join MSMS because we need them to be our voice, tell our story, and support us."