News Briefs: September 18, 2023

Frederick Oncology and Hematology Associates, P.C. (FOHA)—a former medical practice located in Frederick, Maryland—has paid $850,949 to settle allegations it billed Medicare, TRICARE and the Federal Employee Health Benefits Program improperly for evaluation and management (E/M) services with modifier 25, the U.S. Attorney’s Office for the District of Maryland said Sept. 12.[1]  According to the settlement, between Jan. 1, 2013, and Nov. 1, 2017, FOHA billed using CPT codes 99214 and 99215 with modifier 25. The settlement noted that “modifier 25 is only appropriate when there is a separate and distinct evaluation and management service on the same day as a procedure or other service being performed on a patient.”

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