Multiple and bilateral surgery, professional and facility reimbursement policy update

Anthem Blue Cross allows reimbursement to professional providers and facilities for multiple and bilateral surgery. Reimbursement is based on multiple and bilateral procedure rules in accordance with contracts and/or state guidelines for applicable surgical procedures performed at the same session by the same provider.

 

Effective May 1, 2020, the policy has been updated to reflect that multiple procedure guidelines for multiple surgeries do not apply to facility claims.

 

Please visit https://mediproviders.anthem.com/ca to view the Multiple and Bilateral Surgery reimbursement policy for additional information regarding percentages and reimbursement criteria.