Update on Modifier 25 Payment Reductions for Minor Procedures

Originally posted in the June 27, 2024, issue of BCBSNC Provider News

Blue Cross and Blue Shield of North Carolina (Blue Cross NC) has made the decision to rescind the reimbursement policy for evaluation and management (E&M) services with a fifty percent (50%) reduction when performed by the same provider/group practice on the same day as a minor procedure.

This decision to rescind is applicable to all lines of business, including Commercial, Host, State Health Plan (SHP), Federal Employee Program (FEP) and Medicare Advantage.

The above update is in reference to this previously posted Provider News.