Complete Story
07/29/2026
Coding & Compliance Update: 25 Modifier, MIPS Value Pathways, Molina Reimbursement Schedule
Stay in the know with these updates
25 Modifier Resource Compilation
Appropriate use of the 25 modifier is essential. There has recently been an uptick in payers proposing and / or implementing edits to deny payment of Modifier 25 when billing an evaluation and management (E/M) service with a procedure. They are using incorrect utilization and inadequate documentation to support these edits and denials.
When a procedure and an E&M that is significant in nature and separately identifiable from that procedure are both performed, the documentation must clearly reflect two separate services with no overlap in work of the E&M and the work of the procedure and that the E&M did not result in a decision to perform the procedure.
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MIPS Value Pathways (MVPs)
MVPs are one way (an alternative to traditional MIPS and APM Performance Pathway (APP)) that you can meet your MIPS reporting requirements. Each MVP includes a subset of measures and activities related to a given specialty or medical condition.
If you're planning to report a MVP this year, there's one easy step that can derail your MIPS reporting if it's overlooked: CMS requires a separate MVP registration. Many clinicians assume that participating with a qualified registry is enough, but without completing MVP registration through the Quality Payment Program (QPP) portal, you cannot report the MVP.
Proof point: CMS requires clinicians who choose to report an MVP to register through the QPP portal by 8:00 p.m. ET on November 30, 2026.
Registering is straightforward:
· Log in to your QPP account using your HARP credentials.
· Select Register or Edit an MVP Registration.
· Choose the MVP you wish to participate in and your reporting option (individual, group, subgroup, or APM Entity).
· Submit your registration and confirm that your status is marked Complete.
If you report through Registry Clearinghouse, remember that registry enrollment does not automatically complete your CMS MVP registration. Both steps are required.
Next step: If you have not yet registered, log in to the QPP portal and complete your 2026 MVP registration before the November 30, 2026, 8:00 p.m. ET deadline. If you have questions, contact the Registry Clearinghouse team for assistance before the registration window closes. Registry Clearinghouse is a member benefit partner with OHFAMA – Ohio Foot and Ankle Medical Association | Registry Clearinghouse For questions about MVP’s please contact Registry Clearinghouse directly - info@registryclearinghouse.com.
Molina Reimbursement Schedule
OHFAMA members have reached out from across the state, noting a letter from Molina detailing a significant fee reduction in the reimbursement schedule for podiatry.
As your professional association, OHFAMA is working hard behind the scenes through several different avenues to ensure you are reimbursed fairly. Updates will be communicated when available. Please contact our office if you have any questions.
