ASBrS Joins Effort Opposing Proposed Modifier -25 Payment Reduction

The American Society of Breast Surgeons (ASBrS) has joined the American Medical Association and a broad coalition of national medical specialty societies and state medical associations in urging the Centers for Medicare & Medicaid Services (CMS) not to finalize a proposed Medicare payment reduction involving modifier -25.

Under the proposed CY 2027 Medicare Physician Fee Schedule policy, CMS would apply a 50% payment reduction to the lower-valued service when a separately identifiable office or outpatient evaluation and management (E/M) service reported with modifier -25 is provided on the same day as a procedure with a 0-, 10-, or 90-day global period.

In an August 27 letter to CMS, ASBrS and the other signatory organizations expressed concern that the proposed reduction is not supported by sufficient evidence of duplicative resources and could disproportionately affect independent, office-based physician practices. The coalition also noted that existing code valuation processes already account for resource overlap when services are typically furnished together. Rather than implementing an across-the-board payment reduction, the organizations urged CMS to address any demonstrated overlap through targeted, code-specific valuation processes.

View News Archive