Policy Updates Reimbursement PoliciesMedicare AdvantageMedicaidAugust 1, 2024

Reimbursement policy update: Nurse Practitioner and Physician Assistant Services

(Policy G-20002, effective 11/01/2024)

Beginning with dates of service on or after 11/01/2024 Anthem will update the Nurse Practitioner and Physician Assistant Services reimbursement policy as indicated below.

The following services will be removed as physicians’ services:

    • Preventive Services
    • Radiology Services

The following services will be included as physicians’ services:

    • Durable Medical Equipment Prosthetics, Orthotics, and Supplies (DMEPOS)
    • Laboratory Services and Screening Services

For additional information, please review the Nurse Practitioner and Physician Assistant Services reimbursement policy for Medicaid: providers.anthem.com/ca or for Medicare: anthem.com/ca/provider/medicare-advantage.

Anthem Blue Cross is the trade name of Blue Cross of California. Anthem BC Health Insurance Company is the trade name of Anthem Insurance Companies, Inc. Anthem Blue Cross, Anthem Blue Cross Life and Health Insurance Company, Anthem BC Health Insurance Company, and Blue Cross of California Partnership Plan, Inc. are independent licensees of the Blue Cross Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

Blue Cross of California is contracted with L.A. Care Health Plan to provide Medi-Cal Managed Care services in Los Angeles County.

CABC-CDCR-050408-24-CPN49984

PUBLICATIONS: August 2024 Provider Newsletter