At the AMA’s recent House of Delegates Interim Meeting, the ACR’s delegation was able to incorporate rheumatology concerns into official AMA policy, in addition to leading a major multi-specialty resolution on the CMS-proposed move to consolidate and cut evaluation and management (E/M) services. The ACR is able to make this progress because members of the…
Impact of Medicare Billing Changes Varies by Specialty
NEW YORK (Reuters Health)—The proposed collapsing of payment amounts for levels 2 to 5 evaluation and management (E/M) services by the U.S. Centers for Medicare and Medicaid Services (CMS) would have different financial impacts on different specialties, researchers report. “Specialists that tend to have more complicated and/or longer visits would lose money, and specialists that…
ACR Advocates Against Proposed UHC Policy Changes
UnitedHealthcare (UHC) recently proposed two policy changes that would have a negative impact on reimbursement for consultation services and evaluation and management (E/M) services when billed with modifier 25. The effective date for both of these proposed changes is Oct. 1, 2018. Consultation Services Under the proposed consultation codes policy, UHC would end reimbursement for…
Anthem Cancels Planned Modifier 25 Cuts
Anthem, a Blue Cross Blue Shield company that operates in California, Colorado, Connecticut, Georgia, Indiana, Kentucky, Maine, Missouri, New Hampshire, Nevada, New York, Ohio, Virginia and Wisconsin, has decided not to move forward with a policy that would have resulted in decreased reimbursement for evaluation and management (E/M) services when billed with modifier 25. As reported…
Anthem to Reduce E/M Reimbursement When Billed with Modifier 25
Anthem Blue Cross recently announced changes to its reimbursement policies for modifier 25. As of Jan. 1, 2018, Anthem plans in California, Connecticut, Kentucky, Maine, Nevada, New Hampshire, Ohio and Wisconsin will reduce reimbursement for evaluation and management (E/M) services by 50% when billed with modifier 25. This policy will expand to Missouri on Feb….