Author: ICS Staff

BCBSIL – 25 Modifier Letter

A number of chiropractic physicians in Illinois recently received a letter from BlueCross BlueShield of Illinois regarding the use of Modifier 25. Although the exact purpose of the letter was not clearly stated, the letter was sent from BCBSIL’s Special Investigations Department, stating that the practice in question utilized “Modifier 25 with over ninety percent (90%) of established patient Evaluation & Management (E/M) services.”

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Permanent “Doc Fix” Passed, Congress Ushers in New Era of Value-Based Payment

Late last night, the United States Senate overwhelmingly passed legislation to permanently repeal the flawed Sustainable Growth Rate (SGR) formula, the method used by CMS to determine physician reimbursement in the Medicare program. In a bipartisan 92-8 vote, which followed a 392-37 vote in the U.S. House of Representatives at the end of March, the Senate sent House Resolution 2 – known as the “Medicare and CHIP Reauthorization Act of 2015” – to President Obama, who has indicated that he will sign the bill [Update: President Obama signed into law on April 16].

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