CMS and Modifier -25

by L. Neal Freeman, MD, MBA, FACS

In the proposed rule from the Centers for Medicare and Medicaid Services for 2017, CMS continues its long-standing interest in use of the -25 modifier.  Many procedures are often reported with this modifier, meaning that the provider is paid for both the office visit and the procedure.  CMS suspects that this is resulting in overpayments, and therefore has identified 83 services for prioritized investigation.

See the entire text here:
https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-07-07-2.html