As per the new edits, insurers can deny payment for evaluation and management services for a patient when billed on the same day as a vaccine administration code, unless a “modifier 25” is used, according to the release.
AAFP officials have called the edits an “extra barrier” for practices to get proper vaccine administration payments. The Centers for Disease Control and Prevention already lament the low adult immunization rates in the U.S., and the edits will continue to deteriorate vaccine coverage, said AAFP Board Chair Glen Stream, MD.
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