Interprofessional Consultants & Alternative
Delivery Methods for Care:

CMS has changed the way health care is considered and paid not only by Medicare, but many commercial insurance plans also. Part of this change is the mandated requirement for Medicaid to cover many of these services as part of the standardization in health care delivery and reimbursement. More and more health care is provided in non- traditional ways. With the public health emergency, telehealth and telephone services became accepted. With the increase of EMR medical records, there is now coding for digital evaluations. There are also codes for care provided without direct patient involvement. These changes include the Interprofessional consultations between health care providers. Read the full summary >

Cigna Modifier 25 Policy:

Cigna is re-releasing its policy to require the submission of medical records with all Evaluation and Management (E/M) claims with CPT 99212-99215 and modifier 25 when a minor procedure is billed. The updated Cigna policy – Modifier 25-Significant, Separately Identifiable Evaluation and Management Service by the Same Physician on the Same Day of the Procedure or Other Service – is scheduled to become effective nationwide on May 25, 2023.