Reimbursement policy update: Place of Service (Facility)(MAC)

Material adverse change

 

Beginning with dates of service on or after October 1, 2022, Anthem Blue Cross and Blue Shield will update the policy language to indicate the following:

• The title of the policy will be renamed to Place of Service – Facility from Place of Service Evaluation and Management Services – Facility.
• Professional services billed under revenue codes 960-983 are nonreimbursable when submitted on a UB-04.
• Preventive Counseling CPTs 99406–99409, 99411, and 99412 are nonreimburseable when billed in an outpatient setting.

 

As a reminder, Evaluation and Management (E/M) services and other professional services (excluding evaluation and management services rendered in the emergency room and billed with ER revenue codes) are required to be billed on a CMS 1500 form.

 

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

 

 

MULTI-BCBS-COMM-001884-22-CPN1884