AADA fights modifier 25 policy change

October 27, 2017

The American Academy of Dermatology (AADA) is concerned about payers' policy to reduce reimbursement for modifier 25, and is working closely with state dermatology societies and other medical specialty societies in an effort to reverse this policy. Today the AADA held a conference call with Anthem Blue Cross Blue Shield, which will be reducing reimbursement for modifier 25 in California, Connecticut, Kentucky, Maine, Nevada, New Hampshire, Ohio, and Wisconsin starting with claims processed on or after Jan. 1. The AADA expressed its concerns that the policy contradicts well-accepted coding conventions and guidelines, and also issued a letter to Anthem in conjunction state dermatology societies further explaining that the policy is an inappropriate reduction of modifier 25 and should be reconsidered.

The AADA will continue fighting this policy change. To sign up for updates on modifier 25 advocacy efforts, fill out the form here.