Skip To Navigation Skip To Content Skip To Footer
    Hire Physicians Who Fit, Succeed and Stay - Recruit a Physician - Jackson Physician Search and MGMA
    Insight Article
    Home > Articles > Article
    Cristy Good
    Cristy Good, MPH, MBA, CPC, CMPE

    Effective medical billing and coding are essential for accurate reimbursement in medical practices. Two commonly used modifiers, Modifier 25 and Modifier 57, play a crucial role in indicating distinct services and decision-making processes.  

    Modifier 25 

    Use Modifier 25 to signify that a significant, separately identifiable evaluation and management (E/M) service was performed by the same healthcare provider on the same day as another procedure or service. Procedures with a 0- or 10-day global period can be separately reported by using Modifier 25, assuming the E/M service is significant and separately identifiable. When the patient presents with the knowledge that the procedure is going to be done and no other conditions are addressed, the E/M is typically not supported, and Modifier 25 cannot be used. Below are a few scenarios for when to use Modifier 25:

    Sign in to access this material

    Sign In Become a Member
    Cristy Good

    Written By

    Cristy Good, MPH, MBA, CPC, CMPE

    Cristy Good, MPH, MBA, CPC, CMPE, is a Senior Industry Advisor at MGMA, with expertise in practice management, healthcare operations, revenue cycle management and project management. She has more than 20 years of experience in medical practice administration and financial management. Prior to joining MGMA, Cristy was a credentialed trainer with EPIC and helped prepare providers for one of the largest EHR implementations. For more than five years, she was an administrator with a large health system where she oversaw the strategic and daily operations for multiple outpatient medical practices and also spent six months working for a private home health agency. In addition, she has more than 10 years of clinical laboratory experience.

    Explore Related Content

    More Insight Articles

    Ask MGMA
    An error has occurred. The page may no longer respond until reloaded. Reload 🗙