In the Centers for Medicare & Medicaid Services (CMS) proposed 2027 Medicare Physician Fee Schedule rule, CMS proposes significant changes to payment for services using Modifier-25.  In the rule, CMS proposes to reduce payment when a separately identifiable E/M office is furnished by the same physician (or a physician in the same group practice) on the same day as a 0-,10-, or 90-day global procedure.

Under this proposal, the most expensive service (either surgical or E/M visit) would be paid 100 percent, and all other surgical procedures(s) or E/M visit(s) would be paid at 50 percent. This proposal is inherently unfair to office-based physicians who perform minor procedures in their office.

The template letter is editable.  Please feel free to insert an example specific to your practice and/or specialty.