Reimbursement policy update: Frequency Editing (Professional)

Beginning with dates of service on or after December 1, 2020, Anthem Blue Cross and Blue Shield (Anthem) will apply a frequency limit to CPT codes 90791 (Psychiatric diagnostic evaluation) and 90792 (Psychiatric diagnostic evaluation with medical services) with the following limitations:

• 1 per 365 days, per member, per provider NPI for members over 21
• 2 per 365 days, per member, per provider NPI for members under age 21

 

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

 

633-0920-PN-GA