Maine
Provider Communications

Articles Category: Policy Updates

Title Publication Category Date

AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List update

Notice of material change/amendment to contract.
December 2022 Provider Newsletter - Maine Medical Policy & Clinical Guidelines Dec 1, 2022

AIM Specialty Health Genetic Testing Clinical Appropriateness Guidelines CPT Code List update

Notice of material change/amendment to contract.
December 2022 Provider Newsletter - Maine Medical Policy & Clinical Guidelines Dec 1, 2022

Reimbursement policy retirement: Acupuncture Billed with Evaluation and Management - Professional

December 2022 Provider Newsletter - Maine Reimbursement Policies Dec 1, 2022

Reimbursement policy update: Multiple Surgery - Facility

December 2022 Provider Newsletter - Maine Reimbursement Policies Dec 1, 2022

Reimbursement policy update: Bundled Services and Supplies - Professional

Notice of material change/amendment to contract.
December 2022 Provider Newsletter - Maine Reimbursement Policies Dec 1, 2022

Reimbursement policy update: Treatment Rooms with Office Evaluation and Management Services - Facility

Notice of material change/amendment to contract.
December 2022 Provider Newsletter - Maine Reimbursement Policies Dec 1, 2022

Correction to reimbursement policy: Place of Service - Facility

Notice of material change/amendment to contract
November 2022 Provider Newsletter - Maine Reimbursement Policies Nov 1, 2022

Medical policy and clinical guideline updates available on anthem.com

Notice of material change/amendment to contract

November 2022 Provider Newsletter - Maine Medical Policy & Clinical Guidelines Nov 1, 2022

Transition to AIM Specialty Health Perirectal Hydrogel Spacer for Prostate Radiotherapy Clinical Appropriateness Guideline

November 2022 Provider Newsletter - Maine Medical Policy & Clinical Guidelines Nov 1, 2022

Reimbursement policy update: Three-Dimensional (3D) Radiology Services - Professional and Facility

October 2022 Provider Newsletter – Maine Reimbursement Policies Oct 1, 2022

Reimbursement policy update: Multiple and Bilateral Surgery Processing - Professional

Notice of material change/amendment to contract
October 2022 Provider Newsletter – Maine Reimbursement Policies Oct 1, 2022

Reimbursement policy update: Modifier Rules - Professional

Notice of material change/amendment to contract
September 2022 Anthem Maine Provider News Reimbursement Policies Sep 1, 2022

Reimbursement policy update: Modifier 66: Surgical Teams - Professional

September 2022 Anthem Maine Provider News Reimbursement Policies Sep 1, 2022

Reimbursement policy update: Assistant at Surgery (Modifiers 80, 81, 82, AS) - Professional

September 2022 Anthem Maine Provider News Reimbursement Policies Sep 1, 2022

Reimbursement policy update: Place of Service - Facility

Notice of material change/amendment to contract
August 2022 Anthem Maine Provider News Reimbursement Policies Aug 1, 2022

Medical policy and clinical guideline updates are available on anthem.com

Notice of material change/amendment to contract
August 2022 Anthem Maine Provider News Medical Policy & Clinical Guidelines Aug 1, 2022

New reimbursement policy: Transitional Care Management - Professional

July 2022 Anthem Maine Provider News Reimbursement Policies Jul 1, 2022

Retraction for reimbursement policy - Sexually Transmitted Infections – Professional

July 2022 Anthem Maine Provider News Reimbursement Policies Jul 1, 2022

Reimbursement policy update: Treatment Rooms with Office Evaluation and Management Services (facility)

Notice of material change/amendment to contract
June 2022 Anthem Maine Provider News Reimbursement Policies Jun 1, 2022

Updates to AIM Specialty Health Musculoskeletal Clinical Appropriateness Guidelines

Notice of material change/amendment to contract
June 2022 Anthem Maine Provider News Medical Policy & Clinical Guidelines Jun 1, 2022

Updates to AIM Specialty Health Advanced Imaging Clinical Appropriateness Guidelines

Notice of material change/amendment to contract
June 2022 Anthem Maine Provider News Medical Policy & Clinical Guidelines Jun 1, 2022

Updates to AIM Specialty Health Sleep Disorder Management Clinical Appropriateness Guidelines

Notice of material change/amendment to contract
June 2022 Anthem Maine Provider News Medical Policy & Clinical Guidelines Jun 1, 2022

Medical policy and clinical guideline updates available on anthem.com

Notice of material change/amendment to contract
May 2022 Anthem Maine Provider News Medical Policy & Clinical Guidelines May 1, 2022

AIM Specialty Health Outpatient Rehabilitative and Habilitative Services Clinical Appropriateness Guidelines updates

Notice of material change/amendment to contract
March 2022 Anthem Maine Provider News Medical Policy & Clinical Guidelines Mar 1, 2022

Medical policy and clinical guideline updates

Notice of material change/amendment to contract
January 2022 Anthem Maine Provider News Medical Policy & Clinical Guidelines Jan 1, 2022

RETRACTION: Inpatient Facility Transfers - facility reimbursement policy

December 2021 Anthem Maine Provider News Reimbursement Policies Dec 1, 2021

Updates to AIM Specialty Health Musculoskeletal Interventional Pain Management Clinical Appropriateness Guideline

December 2021 Anthem Maine Provider News Medical Policy & Clinical Guidelines Dec 1, 2021

Updates to AIM Specialty Health Cardiology Clinical Appropriateness Guidelines

December 2021 Anthem Maine Provider News Medical Policy & Clinical Guidelines Dec 1, 2021

Updates to AIM Specialty Health Radiation Oncology Clinical Appropriateness Guideline

December 2021 Anthem Maine Provider News Medical Policy & Clinical Guidelines Dec 1, 2021

Updates to AIM Advanced Imaging Clinical Appropriateness Guideline

December 2021 Anthem Maine Provider News Medical Policy & Clinical Guidelines Dec 1, 2021

Reimbursement policy update: Assistant at Surgery (modifiers 80, 81, 82, AS) - professional

December 2021 Anthem Maine Provider News Reimbursement Policies Dec 1, 2021

Reimbursement policy update: Virtual Visits - professional and facility

December 2021 Anthem Maine Provider News Reimbursement Policies Dec 1, 2021

New reimbursement policy update: Modifier 62: Co-Surgeon Services and Modifier 66: Surgical Teams - professional

December 2021 Anthem Maine Provider News Reimbursement Policies Dec 1, 2021

Clarification to reimbursement policy updates: Modifier Rules and Guidelines for Reporting Timed Units for Physical Medicine and Rehabilitation - professional

November 2021 Anthem Maine Provider News Reimbursement Policies Nov 1, 2021

Reimbursement policy clarification: Claims Requiring Additional Documentation - facility

October 2021 Anthem Maine Provider News Reimbursement Policies Oct 1, 2021

New reimbursement policy: Multiple and Bilateral Surgery Processing - facility

October 2021 Anthem Maine Provider News Reimbursement Policies Oct 1, 2021

Medical policy and clinical guideline updates are available on anthem.com

October 2021 Anthem Maine Provider News Medical Policy & Clinical Guidelines Oct 1, 2021

Reimbursement policy update: Sexually Transmitted Infections Testing - professional

September 2021 Maine Provider News Reimbursement Policies Sep 1, 2021

New reimbursement policy: Inpatient Facility Transfers - facility - RETRACTION

September 2021 Maine Provider News Reimbursement Policies Sep 1, 2021

Reimbursement policy update: Drug Screen Testing - professional

September 2021 Maine Provider News Reimbursement Policies Sep 1, 2021

Correction to July 2021 Provider News medical policy update SURG.00017

September 2021 Maine Provider News Medical Policy & Clinical Guidelines Sep 1, 2021

Reimbursement policy update: Claims requiring additional documentation (facility)

August 2021 Maine Provider News Reimbursement Policies Aug 1, 2021

Reimbursement policy update: Distinct Procedural Service, Modifiers 59 and XE, XP, XS, & XU

August 2021 Maine Provider News Reimbursement Policies Aug 1, 2021

Reimbursement policy update:  Virtual Visits - professional and facility

Notice of material change/amendment to contract
August 2021 Maine Provider News Reimbursement Policies Aug 1, 2021

Reimbursement policy update: Consultations - professional

July 2021 Maine Provider News Reimbursement Policies Jul 1, 2021

New reimbursement policy: Non-patient Laboratory Services - facility

July 2021 Maine Provider News Reimbursement Policies Jul 1, 2021

Medical policy updates are available on anthem.com

July 2021 Maine Provider News Medical Policy & Clinical Guidelines Jul 1, 2021

Reimbursement policy update: Claims Requiring Additional Documentation - facility

May 2021 Anthem Maine Provider News Reimbursement Policies May 1, 2021

Reimbursement policy reminder: Readmission - facility

May 2021 Anthem Maine Provider News Reimbursement Policies May 1, 2021

Reimbursement policy update: Frequency Editing - professional

May 2021 Anthem Maine Provider News Reimbursement Policies May 1, 2021

Clinical guideline update available on anthem.com

May 2021 Anthem Maine Provider News Medical Policy & Clinical Guidelines May 1, 2021

New reimbursement policy: Clinic Charges - facility

Notice of material change/amendment to contract
April 2021 Anthem Maine Provider News Reimbursement Policies Apr 1, 2021

Medical policy and clinical guideline updates are available on anthem.com

April 2021 Anthem Maine Provider News Medical Policy & Clinical Guidelines Apr 1, 2021

Reimbursement policy update: Treatment Rooms with Office Evaluation and Management Services - Facility

February 2021 Anthem Maine Provider News Reimbursement Policies Feb 1, 2021

Reimbursement policy update: Multiple Diagnostic Imaging Procedures - professional

January 2021 Anthem Maine Provider News Reimbursement Policies Jan 1, 2021

Reimbursement policy update: Frequency Editing - professional

January 2021 Anthem Maine Provider News Reimbursement Policies Jan 1, 2021

Reimbursement policy update: Guidelines for Reporting Timed Units for Physical Medicine and Rehabilitation - professional

January 2021 Anthem Maine Provider News Reimbursement Policies Jan 1, 2021

Reimbursement policy update: Modifier Rules - professional

January 2021 Anthem Maine Provider News Reimbursement Policies Jan 1, 2021

Reimbursement policy update: Unit Frequency Maximum for Drugs and Biologicals - professional

January 2021 Anthem Maine Provider News Reimbursement Policies Jan 1, 2021

Medical policy and clinical guideline updates are available on anthem.com

January 2021 Anthem Maine Provider News Medical Policy & Clinical Guidelines Jan 1, 2021

Reimbursement policy update: Bundled Services and Supplies - professional

December 2020 Anthem Maine Provider News Reimbursement Policies Dec 1, 2020

Clinical guideline updates are available on anthem.com

November 2020 Anthem Maine Provider News Medical Policy & Clinical Guidelines Nov 1, 2020

Reimbursement policy update - Emergency Department: Leveling of Evaluation and Management Services (facility)

October 2020 Anthem Maine Provider News Reimbursement Policies Oct 1, 2020

Reimbursement policy update: Laboratory and Venipuncture - professional

October 2020 Anthem Maine Provider News Reimbursement Policies Oct 1, 2020

Medical policy and clinical guideline updates

October 2020 Anthem Maine Provider News Medical Policy & Clinical Guidelines Oct 1, 2020

Reimbursement policy update - Claims Requiring Additional Documentation policy (facility)

October 2020 Anthem Maine Provider News Reimbursement Policies Oct 1, 2020

Reimbursement policy update: Distinct Procedural Services - Modifiers 59, XE, XP, XS, XU - professional

September 2020 Anthem Maine Provider News Reimbursement Policies Sep 1, 2020

Reimbursement policy update: Frequency Editing - professional

September 2020 Anthem Maine Provider News Reimbursement Policies Sep 1, 2020

Reimbursement policy update - Claims Requiring Additional Documentation (facility)

August 2020 Anthem Maine Provider News Reimbursement Policies Aug 1, 2020

Medical policy and clinical guideline updates available on anthem.com

July 2020 Anthem Maine Provider News Medical Policy & Clinical Guidelines Jul 1, 2020

New Reimbursement Policy - Nurse Practitioner and Physician Assistant Services - professional

June 2020 Anthem Maine Provider News Reimbursement Policies Jun 1, 2020

Reimbursement policy update: Claims Requiring Additional Documentation (facility)

May 2020 Anthem Maine Provider News Reimbursement Policies May 1, 2020

Medical policy and clinical guideline updates are available on anthem.com

May 2020 Anthem Maine Provider News Medical Policy & Clinical Guidelines May 1, 2020

Clinical guideline update effective June 1, 2020 - Paraesophageal Hernia Repair

March 2020 Anthem Maine Provider News Medical Policy & Clinical Guidelines Mar 1, 2020

Medical policy updates are available on anthem.com

February 2020 Anthem Maine Provider News Medical Policy & Clinical Guidelines Feb 1, 2020

Clinical guideline updates are available on anthem.com

February 2020 Anthem Maine Provider News Medical Policy & Clinical Guidelines Feb 1, 2020

Medical policy updates are available on anthem.com

November 2019 Anthem Maine Provider News Medical Policy & Clinical Guidelines Nov 1, 2019

Clinical guideline updates are available on anthem.com

November 2019 Anthem Maine Provider News Medical Policy & Clinical Guidelines Nov 1, 2019

Medical policy updates are available on anthem.com

September 2019 Anthem Maine Provider News Medical Policy & Clinical Guidelines Sep 1, 2019

Clinical guideline updates are available on anthem.com

September 2019 Anthem Maine Provider News Medical Policy & Clinical Guidelines Sep 1, 2019

New Clinical Guideline: Pneumatic Compression Devices effective December 1, 2019

September 2019 Anthem Maine Provider News Medical Policy & Clinical Guidelines Sep 1, 2019

Bundled Services Reimbursement Policy update - professional

August 2019 Anthem Maine Provider News Reimbursement Policies Aug 1, 2019

Medical policy updates are available on anthem.com

August 2019 Anthem Maine Provider News Medical Policy & Clinical Guidelines Aug 1, 2019

Frequency Editing Reimbursement Policy update - professional

August 2019 Anthem Maine Provider News Reimbursement Policies Aug 1, 2019

Clinical guideline updates are available on anthem.com

August 2019 Anthem Maine Provider News Medical Policy & Clinical Guidelines Aug 1, 2019

Clinical criteria updates for specialty pharmacy

August 2019 Anthem Maine Provider News Medical Policy & Clinical Guidelines Aug 1, 2019

Un-adopted clinical guidelines effective June 1, 2019

July 2019 Anthem Maine Provider News Medical Policy & Clinical Guidelines Jul 1, 2019

New Reimbursement Policy - Ambulance Transportation - professional

June 2019 Anthem Maine Provider Newsletter Reimbursement Policies Jun 1, 2019

Medical policy updates are available on anthem.com

June 2019 Anthem Maine Provider Newsletter Medical Policy & Clinical Guidelines Jun 1, 2019

Coding Updates

June 2019 Anthem Maine Provider Newsletter Medical Policy & Clinical Guidelines Jun 1, 2019

Clinical guideline updates are available on anthem.com

June 2019 Anthem Maine Provider Newsletter Medical Policy & Clinical Guidelines Jun 1, 2019

Coding Updates

June 2019 Anthem Maine Provider Newsletter Medical Policy & Clinical Guidelines Jun 1, 2019

Clinical Guideline CG-ANC-07 effective September 1, 2019

June 2019 Anthem Maine Provider Newsletter Medical Policy & Clinical Guidelines Jun 1, 2019

Medical policy updates are available on anthem.com

May 2019 Anthem Maine Provider Newsletter Medical Policy & Clinical Guidelines May 1, 2019

Clinical guideline updates are available on anthem.com

May 2019 Anthem Maine Provider Newsletter Medical Policy & Clinical Guidelines May 1, 2019

Update regarding evaluation and management with modifier 25 same day as procedure when a prior E/M for the same or similar service has occurred

April 2019 Anthem Maine Provider Newsletter Reimbursement Policies Apr 1, 2019

New Partial Hospitalization Program and Intensive Outpatient Program Services Facility Reimbursement Policy

April 2019 Anthem Maine Provider Newsletter Reimbursement Policies Apr 1, 2019

Injectable Substances with Related Injection Services reimbursement policy update: professional

February 2019 Anthem Maine Provider Newsletter Reimbursement Policies Feb 1, 2019

Body Mass Index reimbursement policy: facility

February 2019 Anthem Maine Provider Newsletter Reimbursement Policies Feb 1, 2019

Significant Edits: professional

February 2019 Anthem Maine Provider Newsletter Reimbursement Policies Feb 1, 2019
Page 1 of 2 Next Page