Policy Updates Reimbursement PoliciesCommercialJuly 1, 2021

Reimbursement policy update: Consultations (professional)

Beginning with dates of service on or after October 1, 2021, Anthem Blue Cross and Blue Shield’s (Anthem’s) current documentation and reporting guidelines for consultations policy will be renamed “Consultations.” This policy aligns with CMS guidance and does not allow reimbursement for inpatient (99251-99255) or outpatient (99241-99245) consultation codes, and requires providers to bill the appropriate office visit Evaluation and Management (E/M) code for consultation services.


For more information about this policy, visit the Reimbursement page on our anthem.com/provider website.


1226-0721-PN-GA