E/M services with modifier 25 appended could be cut by as much as 50%. For example, when you report 99205 (Office or other outpatient visit for the evaluation and management of a new patient...), you normally collect around $210.00, based on the 2017 MPFS values. However, under the new Independence BCBSrules, that number will fall to just $105.00. Say you report 99205-25 twice/day at your practice, you have now lost $1,050/week, or almost $55,000.00 annually from this private payer. (Courtesy TCI Newsletters, Part B Insider, The Coding Institute).
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