Outpatient facility revenue code billing requirements

Effective for all claims received on and after February 1, 2023, in accordance with the Anthem Blue Cross and Blue Shield (Anthem) reimbursement policy titled Outpatient Facility Revenue Code Billing Requirements — Facility, Anthem will implement additional steps to review claims submitted by facilities that contain revenue codes but do not include corresponding CPT^® or HCPCS codes when required by the National Uniform Billing Committee (NUBC).

Anthem requires that current and valid CPT or HCPCS codes are reported with all revenue codes as specified in the NUBC requirements for outpatient claims. Claim lines that do not meet this requirement will be denied.

If you have questions about this policy, contact your contract manager or Provider Relationship Management account representative.