DecisionHealth, DecisionHealth - 2023 Issue 3 (March)

Modifier 25 stays down in ’21, yet practices reap fee gains

Medical groups posted some big numbers in their use of modifier 25 (Significant, separately identifiable E/M service), reporting over 65 million claims and clearing $5 billion in payments in 2021, the latest year of available data. While payments grew, the usage numbers remained down from pre-COVID highs just two years earlier.

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