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Modifier 25: Significant, separately identifiable E/M service When a patient presents for a vaccine and also receives a separately identifiable evaluation and management (E/M) service on the same day, the E/M code is appended with Modifier 25 to indicate that the E/M was distinct from the immunization administration

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Response: We acknowledge that it is difficult to know how many, if any, ACOs joined the Shared Savings Program specifically because they intended to participate for a full 7 years under a one-sided model