Reimbursement policy update: Place of Service - Facility*
*Change to Prior Authorization Requirements
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 non-reimbursable when submitted on a UB-04.
- Preventive Counseling CPTs 99406–99409, 99411, and 99412 are non-reimbursable when billed in an outpatient setting.
As a reminder, Evaluation and Management (E/M) services and 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.
July 2022 Anthem Provider News - Indiana