Payers Are Targeting Modifier 25 Claims — Is Your Revenue Protected?

Insurers are increasingly using advanced analytics to flag Modifier 25 claims for post-payment review. And when documentation doesn’t meet their standards, they initiate recoupments months after the service was provided.

That means revenue you thought was secure can suddenly disappear.

Many payers are now using “pay-and-chase” audit strategies, where claims are initially paid but later reviewed by automated algorithms looking for:

• Documentation gaps
• Incorrect modifier usage
• Insufficient E/M support

When these issues are identified, payers may demand repayment — even long after the visit occurred.

If your organization relies on E/M services billed with procedures, this represents a major financial risk.

Join **Maya Turner, CPC, CPMA, CPCO, for a tactical 60-minute webinar on Monday, April  13 at 1 PM ET, where she will walk through how to protect your reimbursement and strengthen your Modifier 25 compliance.

In this session, you’ll learn how to:

• Identify the most common Modifier 25 documentation mistakes
• Avoid the triggers that lead to payer audits and recoupments
• Defend E/M + procedure claims with compliant documentation
• Reduce denials and protect revenue already earned

Stop leaving your reimbursement vulnerable to payer reviews.

Protect the Modifier 25 Revenue You’ve Already Earned

If your practice bills E/M services with procedures, your Modifier 25 claims are increasingly being targeted for review. The good news? With the right documentation and coding strategy, you can significantly reduce your audit risk.

In this training, you’ll walk away with practical, immediately applicable strategies to help safeguard your reimbursement, including:

• How to apply 2026 E/M documentation standards to make Modifier 25 usage defensible
• The most common documentation red flags that trigger payer record requests• How to properly meet the “separately identifiable” E/M requirement
• Ways to prevent downcoding and revenue loss when procedures are performed during visits
• How to align providers and coders to create consistent, audit-resistant documentation

And much more.

Don’t wait until an audit notice arrives. By the time payers request records, the recoupment process may already be underway.

You provided the care. Make sure your documentation protects the reimbursement.

Reserve your seat today.