AAO-HNS Advocacy Efforts Lead to Blue Cross Blue Shield of North Carolina Modifier 25 Policy Retraction

Following coordinated advocacy by the Academy, the North Carolina Medical Society and physician advocates in the state, Blue Cross Blue Shield of North Carolina (BCBS NC) issued a retraction of its planned Medicare Reimbursement Policy: evaluation and_management_services_MA. As written, effective July 10, the policy would have reduced the reimbursement for E/M services up to 50% when performed by the same provider/group practice on the same day as a minor procedure. The AAO-HNS will continue its ongoing national payer advocacy to ensure that future iterations of this and other Modifier 25 policies allow for full and accurate reimbursement of services performed.