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AAPM&R Advocacy Efforts Result in Reversal of Anthem Modifier 25 Reduction Policy

Feb 26, 2018

In October 2017, AAPM&R began working with a coalition of national medical specialties and state medical associations to advocate regarding our concerns with Anthem’s policy to reduce payment for evaluation and management services billed with modifier 25. 

We are pleased to report that because of this advocacy, Anthem has reversed this policy, which was scheduled to take effect March 1, 2018. 

AAPM&R recognizes that many of our members appropriately use modifier 25 when billing minor procedures with separately reportable evaluation and management services. Were this policy to have taken effect, physiatrists would have experienced a significant decrease to payment. Anthem has indicated it will notify all contracted providers regarding the policy decision in the coming days.   

Learn more about AAPM&R's Advocacy efforts.