DecisionHealth, DecisionHealth - 2025 Issue 3 (March)

Mind your transfer of care modifiers

CMS updated its rules for modifier 54 and reminded providers of the requirements for modifier 55 in the final 2025 Medicare physician fee schedule. While you train staff on the new policy, include a refresher on the full descriptors for the three transfer of care codes. You should also remind them that Medicare and most private payers don’t pay for modifier 56. 

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