tci Part B Insider - 2016 Issue 17

Part B Statistics: Palmetto: 21 Percent of Internal Medicine E/Ms Included Modifier 25

Use this MAC’s data to compare your billings to other internists nationwide. Ever wonder if your modifier billing patterns are “normal?” Now’s the chance to find out. Part B MAC Palmetto GBA published a Comparative Billing Report (CBR) in February to illustrate the way that internal medicine specialists used modifier 25 (Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service). Palmetto launched the analysis after the OIG targeted modifier 25 as one that is vulnerable to fraud...

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