Business of Medicine » Practice Management

Protecting Modifier 25

CMA members’ concerns about a recent reimbursement policy change Blue Shield had announced regarding evaluation and management (E/M) services billed with the Current Procedural Terminology (CPT) modifier 25. The new policy would reduce by 50% reimbursement for any non-preventive E/M service appended with modifier 25 and billed with a minor procedure code.

The Time Is Now to Prepare for the Next VBC Wave

VBC (value-based care) is coming to otolaryngology offices within the next five years through the Centers for Medicare and Medicaid Services (CMS) initiatives, and otolaryngology needs strategies for responding to how value, outcomes, and cost will be captured and measured

Use of Prophylactic Antibiotics in Otolaryngology

Fundamental to medical decision making is the challenging task of weighing the benefits against the risks of any given treatment decision. Clinical guidelines and protocols help with this decision making, which is further informed by physician judgment, particularly when the evidence is weak or lacking.

Challenges in Family Planning and Work–life Integration 

Being fully informed about the logistics of family-planning efforts—whether it’s fertility preservation, in vitro fertilization, or surrogate parenting—and being your own advocate can help physicians through this challenging terrain of work-life integration.