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Society working to address Anthem pay cut for same-day services

The Wisconsin Medical Society, along with the American Medical Association (AMA) and other medical societies, is continuing efforts to prevent a cut in physician reimbursement announced last November by Anthem, Inc. The insurer planned to reduce by 50 percent payments for evaluation and management (E&M) services billed with the CPT modifier 25 when reported with a minor surgical procedure code or preventive/wellness exam.

The AMA, on behalf of state medical societies and its member physicians, sent this letter to Anthem in November asking that the insurer halt plans to implement the cut. In response, Anthem said it would adjust the payment reduction by 25 percent, effective March 1, 2018 instead of January 1.

While this move was a step in the right direction, the Society will continue to work with the AMA and others to eliminate the reduction completely. The AMA House of Delegates adopted policy at the 2017 Interim Meeting specifically opposing such pay reduction for E&M services.

A recent AMA Wire article describes in detail the actions of the AMA regarding this issue.

Back to January 11, 2018 Medigram