Anthem BCBSHigh ImpactReimbursement
[Virginia] Reimbursement policy update: Modifiers 25 and 57: Evaluation and Management with Global Procedures
Published May 3, 2026
AI Summary
Virginia Anthem has updated their reimbursement policy for Modifiers 25 and 57 when used with Evaluation and Management (E/M) services during global procedures. This affects how billing teams must apply these modifiers to ensure proper reimbursement for E/M services provided on the same day as procedures.
Action Required
Immediately: Billing team must review and update modifier usage for E/M services (Modifier 25 for minor procedures, Modifier 57 for major surgeries) when billed with global procedures. Update billing system rules and staff training to ensure compliance with Virginia Anthem's modifier requirements. Verify current claims are following updated guidelines to prevent denials.
Plan Types
Commercial
States
VA
Specialties
all-specialties