New reimbursement policy - Multiple and Bilateral Surgery Processing - facility
Beginning with dates of service on or after January 1, 2022, Anthem will implement a new facility reimbursement policy titled, Multiple and Bilateral Surgery Processing.
We allow reimbursement for only the primary, or highest valued, procedure when multiple or bilateral procedures are performed on the same day or same session, and at the same place of treatment when billed by a facility. A single surgical procedure is subject to multiple procedure reduction guidelines when submitted with multiple units.
For more information about this policy, visit the Reimbursement Policies page at anthem.com.
October 2021 Anthem Maine Provider News