State & FederalAnthem Blue Cross and Blue Shield | Medicare AdvantageMay 1, 2019

Partial hospitalization services

Anthem Medicare Advantage plans follow original Medicare guidelines and billing requirements for partial hospitalization services. CMS regulations (42 CFR 410.43(c)(1)) state that partial hospitalization programs (PHPs) are intended for members who require a minimum of 20 hours per week of therapeutic services as evidenced in their plan of care. All partial hospitalization services require prior authorization. The full article is located online.

 

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