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April 2018

We’re changing the payment policy when evaluation and management services are billed with surgery

Evaluation and management, or E&M, services billed with modifier 25 will pay at 80 percent when billed with a surgery on the same day by the same provider, effective July 1, 2018. This reflects the modified effort to perform the service.

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*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2017 American Medical Association. All rights reserved.