Reimbursement policy update: Frequency Editing (Professional)

Beginning with dates of service on or after April 1, 2021, Anthem has updated our policy to reflect that constant attendance, timed modalities for physical therapy, occupational therapy or speech therapy are limited to 4 Units or 1 hour per date of service for the same member, by the same provider, per therapy type for (97110 – 97124, 97129, 97130, 97140, 97533 – 97542, 97760 – 97763).

Additionally, the policy was updated to remove deleted codes 99363, 99364 and J9031 and add the following codes, effective January 1, 2020: 96158, 96164, 92273, 92274, 93792, 93973 and J9030.

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

928-0121-PN-GA