Modifier 24 vs Modifier 25: Key Differences Explained

Modifier 24 and Modifier 25 are both used with evaluation and management services, but they apply to different billing situations. Modifier 24 is used during a postoperative period when the E/M service is unrelated to the original procedure. Modifier 25 is used when a significant, separately identifiable E/M service occurs on the same day as another procedure or service.

5/25/20263 min read

Modifier Comparisons

Modifier 24 vs Modifier 25: Key Differences Explained

Modifier 24 and Modifier 25 are both used with evaluation and management services, but they apply to different billing situations. Modifier 24 is used during a postoperative period when the E/M service is unrelated to the original procedure. Modifier 25 is used when a significant, separately identifiable E/M service occurs on the same day as another procedure or service.

Understanding the difference can help reduce denials, improve documentation, and support cleaner claim submission.

Author: ModifierLookup
Updated May 2026 • 5 min read

What Is Modifier 24?

Modifier 24 is used when an unrelated evaluation and management service is performed during the postoperative period of a previous procedure.

The key point is that the E/M service must be unrelated to the surgery or procedure that created the global period.

Example:

A patient is recovering from a surgical procedure but returns to the provider for a new respiratory infection. Since the visit is unrelated to the surgery, Modifier 24 may be appended to the E/M code.

What Is Modifier 25?

Modifier 25 is used when a significant, separately identifiable E/M service is performed on the same day as another procedure or service.

The key point is that the E/M work must go beyond the normal pre-service or post-service work associated with the procedure.

Example:

A patient comes in for knee pain. The provider performs a full evaluation and also gives a joint injection during the same visit. Modifier 25 may be appended to the E/M code if the evaluation is separately identifiable.

Key Differences Between Modifier 24 and Modifier 25

Modifier 24:

• Used during a postoperative global period
• Applies to unrelated E/M services
• Used when the visit is separate from surgical follow-up care
• Commonly connected to global surgery billing

Modifier 25:

• Used on the same day as another procedure or service
• Applies to significant, separately identifiable E/M services
• Used when evaluation work goes beyond routine procedure-related care
• Commonly connected to office visits and minor procedures

When to Use Modifier 24

Use Modifier 24 when:

• The patient is in a postoperative period
• The E/M service is unrelated to the original surgery
• A new condition or separate problem is evaluated
• Documentation clearly separates the visit from routine postoperative care

Modifier 24 should not be used for normal follow-up care related to the surgery.

When to Use Modifier 25

Use Modifier 25 when:

• An E/M service occurs on the same day as another procedure
• The E/M service is significant and separately identifiable
• Medical decision-making supports separate evaluation work
• Documentation shows the visit went beyond routine procedural care

Modifier 25 should not be added automatically every time a procedure and office visit occur on the same day.

Common Billing Mistakes

Common Modifier 24 mistakes:

• Using Modifier 24 for routine postoperative follow-up
• Failing to show the E/M service was unrelated
• Missing documentation for the new condition
• Billing during the global period without clear separation

Common Modifier 25 mistakes:

• Using Modifier 25 for routine pre-procedure work
• Appending Modifier 25 without separate documentation
• Billing an E/M service that is already included in the procedure
• Missing medical necessity support

Related Coding and Denial Resources

If the claim issue is tied to CPT coding, review the related CPT code involved in the visit or procedure on CPTCodeGuide.com.

If the claim has already denied, compare the denial reason on DenialCodeLookup.com to understand whether the problem is related to medical necessity, bundling, documentation, or modifier use.

On ModifierLookup, related pages include:

• Modifier 24
• Modifier 25
• Modifier 57

Recent Guides

FAQ

Are Modifier 24 and Modifier 25 both E/M modifiers?

Yes. Both modifiers are used with evaluation and management services, but they apply to different situations.

What is the main difference between Modifier 24 and Modifier 25?

Modifier 24 is used for unrelated E/M services during a postoperative period. Modifier 25 is used for a significant, separately identifiable E/M service on the same day as another procedure.

Can Modifier 24 and Modifier 25 be used together?

Usually no. They address different billing situations. Modifier 24 relates to the postoperative period, while Modifier 25 relates to same-day E/M and procedure billing.