Policy Updates Reimbursement PoliciesCommercialFebruary 1, 2024

Reimbursement policy update: Facility Guidelines for Claims Related to Professional Services — Facility

Beginning with dates of service on or after April 1, 2024, Anthem will not reimburse for the following when billed on a UB-04:

  • Consultation CPT® codes 99242–99245, 99251–99255
    • Prolonged Services codes 99354–99359, 99415–99417 and G2212

For appropriate billing guidelines of Consultation and Prolonged Services CPT codes, please refer to the corresponding professional Reimbursement Policies:

  • Prolonged Services
  • Consultation Services

 For specific policy details, visit the reimbursement policy page at anthem.com:

Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans, Inc. Independent licensee of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

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PUBLICATIONS: February 2024 Provider Newsletter