Is a 25 modifier required with preventitives when immunizations are given?

Our state (MI) Medicaid people are declining to pay when we put a 25 modifier on a preventitive visit charge to distinctly add the immunizations, even though the immunizations are free. Are they correct?

re: Is a 25 modifier required with preventitives when immunizations are given?

I never use a 25 modifier in that situation and I've not had any problems getting paid. I only use the 25 modifier if it's an office visit.

re: Is a 25 modifier required with preventitives when immunizations are given?

There was a payer claims editing system a few years back that required modifier 25 on the 9938X or 9939X codes when an immunization was done. It was totally against coding rules, but they set their editing system up to require it, and so of course, we added. (I can't remember the name of the program, and even if I could, I probably shouldn't mention it :) ) The problem with that is, we do it for one payer because the tell us we have to in order to get paid, and then we keep doing it, and add doing it to other payers and then..... why don't they all follow CPT® rules??