Comment on CMS-2026-2377-0002

My name is Katie Lester, and I serve as a clinic manager for a dermatology practice in Forney, Texas. I have worked in dermatology for the past 12 years, serving patients in our community and helping ensure they receive timely, high-quality care. Every day, I work alongside our physicians, advanced practice providers, and clinical staff to support patients throughout their visits. Our team coordinates biopsies and procedures, educates patients about their diagnoses and treatment plans, schedules appropriate follow-up care, and works to address as many patient needs as possible during a single visit. We strive to provide comprehensive care that minimizes unnecessary return appointments while ensuring our patients receive the treatment they need. The proposed changes to Modifier 25 could have a significant impact on our practice, our providers, and most importantly, our patients. Many of the patients we serve rely on efficient, comprehensive visits because taking additional time away from work, arranging transportation, or traveling back to the office for another appointment can be difficult. When physicians and APPs are able to evaluate a patient, make medical decisions, and perform a medically necessary procedure during the same visit, it improves access to care, reduces delays in treatment, and creates a better overall patient experience. As a clinic manager, I see firsthand the coordination, planning, and teamwork required to provide this level of care. Recognizing the work of physicians and APPs who deliver both evaluation and medically necessary procedures during the same encounter supports high-quality, patient-centered care. Policies that discourage comprehensive visits could increase administrative burden, reduce efficiency, and ultimately make it more difficult for patients to receive timely treatment. I respectfully urge CMS to reconsider the proposed Modifier 25 policy and preserve policies that recognize the value of comprehensive dermatologic care and the dedicated teams who make that care possible. Doing so will help ensure patients continue to have access to efficient, high-quality care in communities like ours.