Reimbursement policy update: Laboratory and Venipuncture Services — Professional and Facility

Beginning with dates of service on or after September 1, 2024, Anthem’s laboratory and venipuncture services reimbursement policy will be expanded to include facility care providers. The related coding section will be updated to clarify coding for professional and facility care providers.

• The following codes will be added to the Facility Section I: Handling, Conveyance of Specimen, and/or Travel Allowance and will not be eligible for separate reimbursement: Select specimen handling CPT®/HCPCS codes: 99000, 99001, P9603, P9604, and H0048.

In addition, the related Coding Section I in the Bundled Services and Supplies policy will be updated to remove these codes.

The following codes will be added to the new Facility Section II: Routine Venipuncture and the Collection of Blood Specimen and will not be eligible for separate reimbursement:

• Venipuncture codes 36400, 36405, 36406, 36410, 36415, 36416, 36591, and 36592, when billed by a facility.

For specific Maine administration policy details, visit tinyurl.com/4n6cj8xw.

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