CommercialReimbursementHigh impact
[Georgia] Reimbursement policy update: Modifiers 25 and 57: Evaluation and Management with Global Procedures
Anthem BCBS·GA·Claims & Billing
We identified it
May 3, 2026
Summary
Anthem Georgia has updated their reimbursement policy for modifiers 25 and 57 when used with Evaluation and Management services during global procedures. This affects how billing teams should code E&M visits that occur on the same day as procedures with global periods.
Action Required
Immediately: Billing team must review current modifier 25 and 57 usage for all E&M services billed with global procedures. Update billing system edits and staff training to ensure proper application of these modifiers per Anthem Georgia's revised guidelines. Verify documentation supports separate E&M services before applying modifiers to avoid claim denials.