Oakland Southfield Physicians

OSP News

Blue Cross Complete Modifier 25 and MTR Reduction Policy Updates

Posted: 07/31/2020

Effective September 1, 2020, Blue Cross Complete will implement two policy updates.  The updates are as follows:

Modifier 25 policy update- Blue Cross Complete will pay a reduced reimbursement of certain evaluation and management procedures billed with CPT modifier 25 when services occur within the minor procedure global surgery timeframes as defined by the Centers for Medicare and Medicaid Services.

MTR policy update - In alignment with the Centers for Medicare and Medicaid Services reimbursement policy on Multiple Therapy Procedures, Blue Cross Complete will reduce reimbursement for multiple therapy services provided on a single service date, for the same individual, by the same provider (as identified by their NPI).

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