Modifier 25 continues to be one of the most confusing and difficult modifiers to use correctly. It’s also one of the most important when it comes to you getting paid more of what you deserve for the E/M services you provide.
Specifically, modifier 25 is used to identify significant, separately identifiable evaluation and management [E/M] service by the same physician on the same day of the procedure or other service. So, failure to apply it accurately means that you will not be paid for the additional services you provide.
So, how can you cut through the confusion and quickly identify when Modifier 25 should be applied?
Simple. Download the E/M Simplified: Modifier 25 Decision Tree Tool. This easy-to-use flow chart pinpoints the rules you must follow to apply modifier 25 correctly, and ensure you are paid for more of the services you provide.