Standardized Reimbursement for Evaluation and Management Services Proposed

Standardized Reimbursement for Evaluation and Management Services Proposed - Healthcare Law Update - March 2026 - Brach Eichler
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3/1/2026

Senate Bill No. 3264, introduced on February 2, 2026, would require health insurance carriers in New Jersey to use the federal resource-based relative value scale (RBRVS) when setting reimbursement rates for certain medical evaluation and management services. The Bill specifically targets billing codes appended by “modifier 25,” which indicates a significant, separately identifiable service beyond another procedure performed the same day. The Bill would apply to insurance companies, HMOs, and the State and School Employees’ Health Benefits Programs.

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For more information, contact:
John D. Fanburg, Chair | 973.403.3107 | jfanburg@bracheichler.com
Edward Hilzenrath, HLU Editor | 973.403.3114 | ehilzenrath@bracheichler.com
Erika R. Marshall | 973.364.5236 | emarshall@bracheichler.com

*This is intended to provide general information, not legal advice. Please contact the authors if you need specific advice.

Related Practices:   Healthcare Law

Related Industry:   Healthcare