CommercialBilling CodesMedium impact
03.00.06ad, 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 Service
Independence Blue Cross·Coding
Effective date
Jan 1, 2026
We identified it
Jun 19, 2026
Summary
This is an updated policy regarding Modifier 25, which is used for significant, separately identifiable evaluation and management services performed by the same provider on the same day as a procedure. The policy provides guidance on proper usage and billing requirements for this commonly used modifier.
Action Required
Before January 1, 2026: Billing team should review the updated Modifier 25 policy at the provided URL to understand any changes to documentation requirements or usage criteria. Update billing staff training and encounter forms to reflect any new guidelines for when Modifier 25 can be appropriately appended to E&M services performed on the same day as procedures.