Independence Blue Cross has implemented a new policy that cuts reimbursements on procedures billed with modifier 25 (“Significant, separately identifiable E/M service”) by half for care given to Medicare Advantage members and patients covered by private insurance plans. The lower rate does not apply to traditional Medicare claims. Independence covers patients under its own name, but also through QCC Insurance Company, Keystone Health Plan Eastand AmeriHealth. The move sets Independence apart from other payers, including Medicare, that reimburse claims reflecting modifier 25 at 100%.
Independence Blue Cross Slashes Reimbursements on Modifier 25