Comment on CMS-2026-2377-0001
Erin LongOpposeIndividual
Summary: A dermatologist opposes the proposed cuts to the 25 modifier, arguing that it would devalue the time spent addressing multiple issues during a single visit. The commenter contends that these changes would negatively impact patient care, reduce access to services, and potentially drive physicians out of the profession.
I am a dermatologist, and I am writing about the devastating effect the payment cuts would have to dermatology as a specialty and patient care. Currently we perform a complete dermatology visit in one: Complete head to toe skin cancer check, refill medications, address new problems, treat precancerous lesions with cryotherapy, and biopsy and often treat skin cancers all at the same office visit. Obviously these are all separate issues. It is already true that if a patient comes in with one solitary issue and there is a procedure involved that there is not an office visit billed, so the 25 modifier is used to state that these are separate identifiably problems. The patient's psoriasis does not have anything to do with their skin cancer, but with the proposed 25 modifier cuts all the time and care talking about other issues would be devalued by any procedure. There is no way to do all of these in one visit with the new proposed 25 modifier cuts, which is not only better patient care, it is less likely for patients to be lost to follow up and improves access to care, since multiple appointments would crowd the schedule, create unhappy patients/constituents, and I can personally promise it would cause many dermatologists to leave the profession, myself included. Please preserve access to physicians as well as allowing patients to have all of their problems addressed in the same visit without devaluing the time spent.