Blood pressure cuff benefits available effective July 1, 2018 for State of Maine employer group members
Effective with dates of service on or after July 1, 2018, State of Maine employer group members have benefits available for a blood pressure cuff, HCPCS code A4670, when they have a prescription from their doctor. When obtained from an in-network durable medical equipment (DME) supplier, the claim will process at 100% of the maximum allowance. When obtained from an out-of-network DME supplier, the member will be responsible for their out-of-network cost sharing, plus balance billing (amounts above the maximum allowance).
Please note that a prescription is required for benefits to be available. When prescribing a blood pressure cuff for a State of Maine member, please be sure to refer to a participating DME provider to maximize the member’s benefits.
August 2018 Anthem Maine Provider Newsletter