Anthem Blue Cross and Blue Shield in Indiana (Anthem) would like to thank you for your continued participation in Anthem’s networks. We want to make you aware of changes to the Anthem fee schedules*.

 

The new Anthem fee schedules will apply to covered services rendered on or after November 1, 2022 for PPO (Blue Access®), HMO (Blue Preferred®), Traditional (Blue Traditional®), HealthSync Networks, and any other Anthem networks whose Anthem rate is based on these fee schedules.  This includes those CPT codes whose Anthem rate is based on the fee schedule for the Anthem Indiana Medicaid Network (HHW and HHC).

 

Click here to view the sample fee schedule with the most frequently utilized CPT® codes and the corresponding maximum allowable amounts. This fee schedule is only a sampling and is not meant to be representative of all changes that are being made to the Anthem fee schedules. All updates to the fee schedules, represent increases to the previous allowable amounts.

 

If you have a question concerning the reimbursement amount of any specific CPT code, we encourage you to access the online fee schedule tool at MyAnthem via the Availity web portal. Go to www.Availity.com and select the Anthem provider portal.  Please note that the online fee schedules provides reimbursement amounts for current as well as historical fee schedules.

 

The updated fee schedules with an effective date of November 1, 2022 are available on the Availity web portal at MyAnthem on or after October 31, 2022.

 

Anthem will continue to update quarterly those fees tied to the Indiana Medicare schedules (drugs, durable medical equipment, orthotics and prosthetics for example), in conjunction with Indiana Medicare’s fee schedule changes. Some generic drugs, however, may be updated in conjunction with, or off-cycle of, the Indiana quarterly Medicare updates.

 

Please keep in mind that Anthem reimburses physician extenders such as nurse practitioners, physician assistants, certified registered nurse anesthetists, etc. according to the Health Professional Practitioner Fee Schedule. This is a separate fee schedule that is approximately 85% of the standard physician fee schedule. 

 

Additionally, some midlevel mental health provider specialties such as licensed clinical social workers, licensed marriage and family therapists, etc. may be reimbursed at a reduced rate. This rate of reimbursement is approximately 80% of the standard physician fee schedule. For details on specific CPT codes, you may access Anthem’s online fee schedule tool.

 

If you have any questions, please contact your designated Network Representative.

 

Again, thank you for the services you provide for Anthem members.

 

*Please note that these fee schedule changes do not apply to health care professionals that are located in the Indiana counties of Washington, Crawford, Harrison, Floyd, Clark, Scott, and Jefferson.
INBCBS-CM-013422-22
Availity, LLC is an independent company providing administrative support services on behalf of Anthem Blue Cross and Blue Shield.



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Important notice regarding Anthem fee schedule changes - Indiana