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Blue Shield to significantly cut reimbursement of E/M services billed with modifier 25 and will no longer pay consult codes

Blue Shield of California recently notified physicians of two upcoming changes to the payor’s policies. Effective July 14, 2024, Blue Shield will no longer reimburse for face-to-face consultation services (CPT codes 99242-99245 or 99252-99255). Additionally, the notice states it is changing its Global Surgical Period Payment Policy, which will significantly reduce reimbursement for evaluation and management (E/M) services billed with modifier 25.     Consultation Codes Blue Shield is the latest payor to announce it will no longer reimburse consultation services. Consultation services, including telehealth consults, previously represented by CPT codes 99242-99245 and 99252-99255 ...