Understand when to use modifier 25 so that you are paid correctly as well as how it affects the new add-on code G2211.

Mar 25, 2022 · Modifier 25 indicates that additional reimbursement is needed to account for the extra E/M work. The key is recognizing when the additional work is “significant” and, therefore, additionally …

Modifier 25, Significant, Separately Identifiable Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional on the Same Day of the Procedure or Other …

Use modifier 25 with the appropriate level of E/M service. Modifier 25 indicates on the day of a procedure, the patient's condition required a significant, separately identifiable E/M service, above …

The definitive 2025 CPT Modifiers list. Learn when to use Informational vs. Payment modifiers, navigate NCCI edits, and download our quick-reference cheat sheet.

Use to indicate that an E/M service was provided on same day as another procedure that would normally bundle under National Correct Coding Initiative (NCCI). In this situation, this modifier …

When you submit a claim to the insurance carrier that is coded with a 25 Modifier, you are telling the carrier to pay you for both the E/M visit and the minor procedure. Often in the past claims with both …

To append modifier –25 appropriately to an E/M code, the service provided must meet the definition of “significant, separately identifiable E/M service” as defined by CPT.

Feb 16, 2026 · Modifiers are one of the most important—and most misunderstood—elements in medical billing. They play a critical role in communicating the details of a service to payers, clarifying when …

Modifier 25, Significant, Separately Identifiable Evaluation and Management Service by the Same Physician or Other Qualified Health Care Professional on the Same Day of the Procedure or Other …