New reimbursement policy: Clinic Charges - facility

A new facility reimbursement policy titled Clinic Charges will be implemented beginning with dates of service on or after July 1, 2021.  This policy indicates that a facility will not be reimbursed for clinic services rendered to a covered individual by a professional provider at any clinic that is owned, operated or controlled by a facility or health system when billed on a UB-04. Services that are rendered in an office, professional building, medical office building, free standing clinic or other associated spaces must be billed on a CMS-1500.

 

For more information about this policy, visit the Reimbursement Policies page at anthem.com.  

 

1029-0421-PN-NE