Modifier 25: Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service
The Empire BlueCross BlueShield HealthPlus (Empire) Modifier 25 reimbursement policy provides the criteria for reimbursement for a significant, separately identifiable evaluation and management (E&M) service performed by the same provider on the same day of the original service or procedure. Effective May 1, 2019, Empire does not allow separate reimbursement for E&Ms performed on the same day as a major surgery (90-day global period).
For additional information, refer to the Modifier 25 reimbursement policy at www.empireblue.com/nymedicaiddoc.
February 2019 Empire Provider Newsletter