This is new to me as I have not had to deal with group therapy coding along with the E/M coding. According to the NCCI edit, a group therapy session cannot be billed on the same day as a subsequent hospital visit. However, the listing also states that the use of a modifier is acceptable. Prior to my starting this, the group used modifier -25 on the E/M service and was paid for both codes. Within the last few months, it has changed and most payers are only reimbursing for one code or the other; sometimes the group and sometimes the E/M service. Does anyone have any experience with this? Maybe you could provide a bit of insight into this? Thanks!
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