Anthem Blue Cross (Anthem) notified our contracted Applied Behavior Analysis (ABA) providers on November 26, 2019, of an update regarding ABA reimbursement scheduled to take effect on March 1, 2020.


On February 28, 2020, a provider notification was sent to those impacted ABA providers notifying them that Anthem is temporarily delaying the March 1, 2020 fee schedule adjustments for ABA providers. Until further notice, Anthem will honor the rates for ABA services in their current Agreement with Anthem.


While system updates are being made to ensure claims are processed correctly, Anthem suggests that claims with dates of service between March 1, 2020 and March 10, 2020 are not submitted until March 11, 2020 to avoid underpayments.


It is important to remember that your reimbursement is proprietary information that should remain confidential, and is specific to your Agreement with Anthem.


Please call the Autism Spectrum Disorder Program toll-free at 1-844-269-0538 for questions regarding utilization management for ABA.


If you have general questions about your reimbursement or Agreement, email our commercial Behavioral Health Network Relations team at 

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April 2020 Anthem Blue Cross Provider News - California