On April 15, 2026, Blue Cross Blue Shield of Michigan (BCBSM) issued a Provider Alert announcing their decision to pause the implementation of a new reimbursement policy that would have reduced payment by 50 percent for E/M codes appended with modifier 25 and billed with a minor procedure.
This policy was originally announced in the February edition of BCBSM’s The Record and further clarified in a Policy Update later that month. Through ongoing correspondence with BCBSM and a coordinated communications strategy, the Michigan State Medical Society (MSMS) expressed serious concerns with the policy change as it would have broadly impacted physician practices and patients across the state. We are grateful to all who joined in sharing their concerns and examples of the policy’s real-world impact.
On March 24, 2026, we met directly with BCBSM leadership, bringing together a focused contingent of leaders from MSMS, specialty societies, Physician Organizations, American Medical Association, and Michigan Health & Hospital Association. MSMS appreciated BCBSM’s willingness to listen to and take into consideration the concerns expressed by our group on behalf of the physician community.
“The ability to engage in collaborative and mutually respectful dialogue with Doctor Grant[i], Doctor Milewski[ii], and other BCBSM leaders over the past couple of months enabled us to provide relevant information for their perusal as they re-examined this policy,” noted MSMS CEO Tom M. George, MD. “We are thankful for their decision and look forward to working with BCBSM in the future on efforts to improve health care quality, access and affordability.”
If you have questions, please feel free to contact Dara J. Barrera, MSMS Director of Health Care Quality, Equity and Technology at djbarrera@msms.org or 517-336-5770 or Stacey P. Hettiger, MSMS Senior Director of Advocacy and Payor Relations at shettiger@msms.org or 517-336-5766.
Find previous articles on this topic in these communications:
- MSMS Leads Contingent in Meeting with BCBSM on Modifier 25
- BCBSM New Modifier 25 Policy: What Physicians Need to Know
- Update: BCBSM Clarifies Modifier 25 Policy But Reduction Remains
- MSMS Leads Effort to Challenge BCBSM’s Modifier 25 Reimbursement Reduction
- BCBSM Announces Reimbursement Reduction for Non-preventive E/M Services Billed with Modifier 25
[i] James D. Grant, MD, MBA, Senior Vice President and Chief Medical Officer, BCBSM
[ii] Amy Milewski, MD, MBA, Vice President of Clinical Partnerships and Associate Chief Medical Officer, BCBSM