The Pulse

A bi-weekly newsletter from your physician organization to keep you informed of today's healthcare news

Friday, April 24, 2026

 

BCBSM Pauses Modifier 25 Policy Change

Blue Cross Blue Shield of Michigan (BCBSM) recently announced a pause on its planned Modifier 25 policy update that would have reduced payment for certain E/M codes billed with Modifier 25 on the same date as a minor procedure.

 

This decision follows feedback from physicians and partners regarding the potential impact on workflow, administrative burden, and patient access to care.

Improve documentation, coding on variety of health issues

Mark your calendars for live coding webinars hosted by Blue Cross Blue Shield of Michigan (BCBSM). The webinars will focus on documentation and coding of various health issues to improve quality care and revenue.


Sessions start at noon Eastern time and run for either 30 or 45 minutes. Register on the provider training website. After logging in to the provider training website, look in Event Calendar to sign up for your desired session.


Upcoming dates include:


June 10: Coding acute conditions in the outpatient setting


July 15: Annual Medicare Wellness Visits Q&A Forum


Aug. 12: Diabetes coding changes


Sept. 16: Oncology coding and documentation


Oct. 14: ICD-10-CM Updates


Nov. 18: OBGYN tips for coding


Dec. 9: CPT updates for 2027

Protecting the most valuable asset physicians often

overlook: their income

Physicians spend years investing in their education, training, and clinical expertise - yet many overlook the importance of protecting the very asset that makes it all worthwhile: their ability to earn an income.


Disability insurance is not just about having coverage; it’s about having the right coverage. The definition of disability within a policy is one of the most critical—and often misunderstood—components. Many policies fall short when it comes to how they define a physician’s ability to work, especially in specialty-specific scenarios.


For example, if a surgeon loses fine motor skills or a procedural specialist can no longer perform key duties, the question becomes: does their policy recognize them as “disabled” even if they can still work in another capacity? The answer depends entirely on how the policy is structured.


Over the past decade, we’ve seen meaningful shifts in policy design, contract language, and how carriers interpret occupation-specific claims. Small differences in wording can lead to significant differences in outcomes at claim time.


Equally important are factors like benefit period, residual/partial disability coverage, portability, and how policies integrate with employer-provided benefits. Many physicians assume they are fully protected through group plans, only to discover gaps when it matters most.


The reality is this: disability insurance should be tailored with the same precision physicians apply to patient care. A one-size-fits-all approach rarely aligns with the complexity of a medical career. A disability insurance provider should work with a physician to review and pressure-test existing coverage, ensuring it aligns with the individual's specialty, income trajectory, and long-term goals.


Source: Lifetime Financial Growth of Michigan, one of TPA's Affiliate Partners, helps physicians protect their income from disability, injury, or illness. Discounts available for some categories. To learn more, contact Chip Egbert at chip.egbert@lfgco.com, 248-425-4351 or Brian Kaufman at brian.kaufman@lfgco.com, 248-909-2639.

Stay updated on the latest healthcare news

You can order your own blood work now. Interpreting the results is another story, NPR

As US Birth Rate Falls, Feds’ Response May Make Pregnancy More Dangerous, Kaiser Health News

Trinity Health to open $226M replacement hospital, Becker's Hospital Review

For Many Patients Leaving the ICU, the Struggle Has Only Just Begun, Kaiser Health News

State lowers vaccine age recommendation in SE Michigan amid measles outbreak, Bridge Michigan

Younger adult colon cancer deaths are concentrated in people with less education, study says, Associated Press

Michigan eyes cuts to mandatory overtime for nurses, Becker's Clinical Leadership

Your New Therapist: Chatty, Leaky, and Hardly Human, Kaiser Health News

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Learn more about this partner.