Reimbursement policy updates for facilities

We previously shared the following policy which will be effective for dates of service on/or after January 1, 2024.

• Bundled Services and Supplies‑Facility

New reimbursement policy: Bundled Services and Supplies — Facility

Anthem will implement a new facility reimbursement policy titled Bundled Supplies and Services-Facility. This policy identifies certain services and/or supplies ineligible for separate reimbursement when billed by a facility. These identified services and/or supplies are an integral component to the overall procedure.

The Related Coding section of the policy includes a list of the CPT^® and HCPCS Level II codes that are considered as always bundled and not eligible for reimbursement when reported as a stand‑alone service or with another service. Modifiers are not accepted as an override for reimbursement for always bundled services and/or supplies.

To view the reimbursement policies, log in to https://Availity.com, select Anthem Blue Cross in the Payer Spaces, then select Information Center. Select Administrative Support, then select the Reimbursement Policies — Facility and Professional link. Reimbursement policies are listed in alphabetical order.

If you are not registered for Availity Essentials, go to https://Availity.com and go to the upper right‑hand corner to complete the registration process.

To view the reimbursement policies, log in to https://anthem.com/ca/provider. Go to For Providers > Policies, Guidelines & Manuals. Scroll down to Reimbursement Policies and select Access Policies. Policies are listed in alphabetical order.

Contact us

Availity Chat with Payer is available during normal business hours. Get answers to your questions about eligibility, benefits, authorizations, claims status, and more. To access Availity Essentials, go to https://Availity.com and select the appropriate payer space tile from the drop‑down. Then, select Chat with Payer and complete the pre‑chat form to start your chat.

For additional support, visit the Contact Us section of our provider website for the appropriate contact.