CMS Set to Release Comparative Billing Report on Modifier 25: Family Practice

In the November 6, 2014 MLN Connects Provider eNews, CMS announced that it will issue a national provider Comparative Billing Report (CBR) in November 2014 on the use of Modifier 25 by family practice providers. Modifier 25 is used to indicate “significant, separately identifiable evaluation and management (E/M) service by the same physician on the day of a procedure.” The CMS announcement explains that the CBR will “focus on family practice providers and will contain data-driven tables and graphs with an explanation of findings that compare these providers’ billing and payment patterns to those of their peers in their state and across the nation.” CMS contracts with eGlobalTech to produce the CBRs.

CBRs are intended to be a tool to help providers gain a better understanding of applicable Medicare billing rules. CBRs are not made publically available; the reports are only accessible to those providers who receive them.

The default method for sending CBRs is by fax. As a result, providers are encouraged to update their fax numbers in the Medicare Provider Enrollment Chain and Ownership System (PECOS). Providers that prefer to receive CBRs through the U.S. Postal Service can contact the CBR Support Help Desk or CBRsupport@eglobaltech.com.

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