While supplies last! Free 2022 Coding Essentials for Infusion & Injection Therapy Services book with every RACmonitor webcast order. No code required. Order now >

A proposed 50 percent reduction in claims submitted with modifier 25 is on the table.

The Centers for Medicare & Medicaid Services (CMS) is proposing a 50 percent reduction in reimbursement for claims submitted using modifier 25, according to Shannon DeConda, an evaluation and management (E&M) coding expert.

DeConda reported on the proposed reduction during today’s Monitor Mondays broadcast. DeConda said that with all the concerns regarding CMS’s proposed E&M reimbursement model change and documentation relaxation initiatives, many providers and stakeholders have failed to notice the other changes being floated.

“If accepted as final rule, when a 25 modifier is reported on a claim, the service with the lower reimbursement rate will be reduced by 50 percent,” DeConda told Monitor Mondays audience members. “This reduction is in addition to the proposed flat-rate E&M reimbursement proposal, representing significant financial implications for most practices and organizations treating Medicare beneficiaries.”

As reported by RACmonitor, the proposed E&M changes have continued to generate controversy. Public comment on the proposed E&M changes, found in the 2019 Medicare Physician Fee Schedule, will extend until Sept. 10.

Program Note: Register to listen to the Shannon DeConda webcast on the proposed E&M changes on Aug. 23 at 1:30 p.m. EST.

 

Comment on this article

Facebook
Twitter
LinkedIn
Email
Print

Chuck Buck

Chuck Buck is the publisher of RACmonitor and is the program host and executive producer of Monitor Monday.

You May Also Like

Leave a Reply

Your Name(Required)
Your Email(Required)