Anthem delays, alters proposed modifier 25 policy following AADA, AMA advocacy

December 22, 2017

Anthem, Inc. announced on Dec. 22, 2017 that, while it will still be reducing reimbursement for E&M services billed with a modifier 25, reimbursement will be reduced by 25 percent rather than by 50 percent, as was originally announced. Anthem also announced that the policy will go into effect March 1, 2018 in California, Colorado, Connecticut, Indiana, Kentucky, Maine, Missouri, New Hampshire, Nevada, New York, Ohio, and Wisconsin. For some states, this is a delay in implementation. Anthem also indicated that the policy will be effective in Georgia and Virginia upon network contract renewal. Click here to read the Academy's Breaking News Alert for more on the American Academy of Dermatology Association's efforts to fight Anthem's proposed policy change along with the American Medical Association (AMA), other medical specialties, and state dermatologic societies.