Reimbursement policy update: Place of Service - Facility

 

Beginning with dates of service on or after November 1, 2022, Anthem will update the policy language to indicate the following:

• The title of the policy will be renamed Place of Service – Facility. The previous policy title was Place of Service Evaluation and Management Services – Facility.
• Professional services billed under revenue codes 960-983 are nonreimbursable when submitted on a UB-04, excluding revenue code 964.
• Preventive Counseling CPT codes 99406 – 99409, 99411, 99412 are nonreimburseable when billed in an outpatient setting.

 

As a reminder, Evaluation and Management (E/M) services and other professional services (excluding E/M services rendered in the emergency room and billed with ER revenue codes) are required to be billed on a CMS 1500 form.

 

For specific policy details, visit the reimbursement policy page at anthem.com.

 

MEBCBS-CM-003486-22