Anthem has decided not to move forward with its policy to reduce payments for evaluation and management (E&M) services reported on the same day as clinical procedures with a current procedural terminology (CPT) modifier 25, according to the American Medical Association (AMA).
In December, the AMA noted that Anthem had adjusted its proposed policy to reduce payments for E&M codes reported with CPT modifier 25 by 25% instead of 50%. However, the AMA and other physician organizations -- including the American College of Radiology (ACR) -- continued to object to this reduction in physician payment and presented additional analyses of the relevant codes and services to Anthem. The policy was scheduled for implementation on March 1.
In late February, the insurer decided against proceeding with the policy, according to the AMA.
"Anthem's decision to drop its planned modifier 25 policy is a positive step forward, demonstrating again that when doctors and health plans work together, the best outcome for patients can be achieved," said AMA chair-elect Dr. Jack Resneck Jr. in a statement.
