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Surgery Reimbursement Cutback when Billing with Modifiers 54 and 55 Delayed

March 15, 2016

The implementation of the Centers for Medicare & Medicaid Services (CMS) physician fee schedule cutback percentages for HCPCS surgery codes billed with modifier 54 (surgical care only) and modifier 55 (postoperative management only) was delayed until November 1, 2015. An Erroneous Payment Correction will reprocess affected claims with dates of service on or after September 1, 2014.