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CMS Proposed Policy: -0-day Global Services that are Typically Billed with an (E/M) Service with Modifier 25

July 08, 2016

CMS has noted that several high volume procedure codes are typically reported with a modifier that unbundles payment for visits from the procedure, even though the modifier should only be used for reporting services beyond those usually provided. Therefore, CMS believes the services may be misvalued. As a result, CMS is proposing to prioritize 83 services for review as potentially misvalued.

 

CMS.gov Fact sheet


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