CommercialDecember 1, 2022
Reimbursement policy update: Treatment Rooms with Office Evaluation and Management Services - Facility (MAC)
Material adverse change
Beginning with dates of service on or after March 1, 2023, Anthem Blue Cross and Blue Shield (Anthem) will update the Related Coding section of the Treatment Rooms with Office Evaluation and Management Services – Facility policy to include HCPCS code G0463. The code description for G0463 is hospital outpatient clinic visits or assessment and management of a patient. G0463 is not eligible for reimbursement when reported with revenue code 760, 761, or 769.
Beginning with dates of service on or after March 1, 2023, Anthem Blue Cross and Blue Shield (Anthem) will update the Related Coding section of the Treatment Rooms with Office Evaluation and Management Services – Facility policy to include HCPCS code G0463. The code description for G0463 is hospital outpatient clinic visits or assessment and management of a patient. G0463 is not eligible for reimbursement when reported with revenue code 760, 761, or 769.
For specific policy details, visit the reimbursement policy page on the anthem.com provider website.
PUBLICATIONS: December 2022 Anthem Provider News - Georgia
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