Material adverse change (MAC)

Beginning with dates of service on or after April 1, 2022, Anthem Blue Cross and Blue Shield (Anthem) will no longer allow separate reimbursement for 88141-88155, 88164-88167, and 88174-88175 when reported with 99381-99397, 99201-99215. We will bundle these codes, and modifiers will not override the edit. The “exemption” section of the policy will reflect this change.

Additionally, the same changes apply to our Distinct Procedural Service, Modifiers 59 and XE, XP, XS, & XU policy.


For more information about these policies, visit the Reimbursement Policy page on our website.



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January 2022 Anthem Provider News - Georgia