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Modifier 25 Reduction for Same Day Services Rolled Back

March 1, 2018

A very significant step in the pushback against the trend of slicing into physician revenue by insurance carriers was taken this month as Anthem rescinded its January 1, 2018 policy for same day services.  Previously the policy intended to reduce E/M reimbursement by 50% when rendered on the same day as qualifying procedures.  After a push by physicians, this policy has been rolled back to March 1, 2018 and from 50% to 25%.  Continued efforts by physicians and the AMA will hopefully put a complete stop to the policy altogether, but that is left to be seen.

AMA Article link below here…

https://wire.ama-assn.org/practice-management/win-doctors-anthem-rescinds-pay-cut-same-day-services


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