Maine
Provider Communications

Articles Category: Policy Updates

Title Publication Category Date

“Rule of Eight” Reporting Guidelines for Physical Medicine and Rehabilitation Services: professional

December 2018 Anthem Maine Provider Newsletter Reimbursement Policies Dec 1, 2018

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

Updates to AIM Specialty Health Radiation Oncology Clinical Appropriateness Guidelines

Notice of material change/amendment to contract.
January 2023 Provider Newsletter - Maine Medical Policy & Clinical Guidelines Dec 30, 2022

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 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 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 Musculoskeletal - Interventional Pain Management Clinical Appropriateness Guidelines

Notice of material change/amendment to contract.
January 2023 Provider Newsletter - Maine Medical Policy & Clinical Guidelines Dec 30, 2022

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 Cardiac Clinical Appropriateness Guidelines

Notice of material change/amendment to contract.
January 2023 Provider Newsletter - Maine Medical Policy & Clinical Guidelines Dec 30, 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 Advanced Imaging Clinical Appropriateness Guidelines

Notice of material change/amendment to contract.
January 2023 Provider Newsletter - Maine Medical Policy & Clinical Guidelines Dec 30, 2022

Updates to AIM Advanced Imaging Clinical Appropriateness Guideline

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

Update: AIM Specialty Health Cardiology Clinical Appropriateness Guidelines CPT Code List

January 2023 Provider Newsletter - Maine Medical Policy & Clinical Guidelines Dec 30, 2022

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

Update on clinical guideline communication in October 2018 provider newsletter

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

Update on clinical guideline communication in October 2018 provider newsletter

December 2018 Anthem Maine Provider Newsletter Medical Policy & Clinical Guidelines Dec 1, 2018

Un-adopted clinical guidelines effective June 1, 2019

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

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

System updates for 2019: professional

December 2018 Anthem Maine Provider Newsletter Reimbursement Policies Dec 1, 2018

Significant Edits: professional

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

Scope of License reimbursement policy update: professional

December 2018 Anthem Maine Provider Newsletter Reimbursement Policies Dec 1, 2018

Routine Obstetrical Services update: professional

October 2018 Anthem Maine Provider Newsletter Reimbursement Policies Oct 1, 2018

Review of reimbursement policies – professional

June 2018 Maine newsletter Reimbursement Policies Jun 19, 2018

RETRACTION: Inpatient Facility Transfers - facility reimbursement policy

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

Retraction for reimbursement policy - Sexually Transmitted Infections – Professional

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

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: Virtual Visits - professional and facility

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

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

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

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

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: 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

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

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

Reimbursement policy update: Sexually Transmitted Infections Testing - professional

September 2021 Maine Provider News Reimbursement Policies Sep 1, 2021

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

Reimbursement policy update: Multiple Diagnostic Imaging Procedures - 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: Modifier 66: Surgical Teams - Professional

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

Reimbursement policy update: Laboratory and Venipuncture - professional

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

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: Frequency Editing - professional

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

Reimbursement policy update: Frequency Editing - professional

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

Reimbursement policy update: Frequency Editing - professional

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

Reimbursement policy update: Drug Screen Testing - professional

September 2021 Maine Provider News Reimbursement Policies Sep 1, 2021

Reimbursement policy update: Documentation and Reporting Guidelines for Evaluation and Management Services - Professional

April 2023 Provider News - Maine Reimbursement Policies Mar 31, 2023

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

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

Reimbursement policy update: Claims Requiring Additional Documentation - facility

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

Reimbursement policy update: Claims requiring additional documentation (facility)

August 2021 Maine Provider News Reimbursement Policies Aug 1, 2021

Reimbursement policy update: Claims Requiring Additional Documentation (facility)

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

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: Bundled Services and Supplies - professional

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

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

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

Reimbursement policy update: Multiple Surgery - Facility

December 2022 Provider Newsletter - Maine Reimbursement Policies Dec 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 - Emergency Department: Leveling of Evaluation and Management Services (facility)

October 2020 Anthem Maine Provider News Reimbursement Policies 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 - Claims Requiring Additional Documentation (facility)

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

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

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

Reimbursement policy reminder: Readmission - facility

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

Reimbursement policy clarification: Claims Requiring Additional Documentation - facility

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

Reimbursement for convenience surgical supply kits: professional

December 2018 Anthem Maine Provider Newsletter Reimbursement Policies Dec 1, 2018

Readmissions Reimbursement Policy update: facility

October 2018 Anthem Maine Provider Newsletter Reimbursement Policies Oct 1, 2018

Outpatient facility revenue code billing requirements

January 2023 Provider Newsletter - Maine Reimbursement Policies Dec 30, 2022

Once per Lifetime Procedures - professional

August 2018 Anthem Maine Provider Newsletter Reimbursement Policies Aug 1, 2018

Notification Regarding Reimbursement Changes to COVID-19 Vaccine Administration

Notice of material change/amendment to contract.
April 2023 Provider News - Maine Reimbursement Policies Mar 31, 2023

New reimbursement policy: Transitional Care Management - Professional

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

New reimbursement policy: Non-patient Laboratory Services - facility

July 2021 Maine Provider News Reimbursement Policies Jul 1, 2021

New reimbursement policy: Multiple and Bilateral Surgery Processing - facility

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

New reimbursement policy: Inpatient Facility Transfers - facility - RETRACTION

September 2021 Maine Provider News Reimbursement Policies Sep 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

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

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

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

New Reimbursement Policy - Ambulance Transportation - professional

June 2019 Anthem Maine Provider Newsletter Reimbursement Policies Jun 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

New Facility Revenue Code Billing Reimbursement Policy

October 2018 Anthem Maine Provider Newsletter Reimbursement Policies Oct 1, 2018

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

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

Multiple Diagnostic Imaging Reimbursement Policy update: facility

October 2018 Anthem Maine Provider Newsletter Reimbursement Policies Oct 1, 2018

Modifier 79: Unrelated Procedure or Service by the Same Physician or Other Qualified Health Care Professional during the Postoperative Period: professional

December 2018 Anthem Maine Provider Newsletter Reimbursement Policies Dec 1, 2018

Medical policy updates are available on anthem.com

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

Medical policy 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

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

Medical policy updates are available on anthem.com

October 2018 Anthem Maine Provider Newsletter Medical Policy & Clinical Guidelines Oct 1, 2018

Medical policy updates are available on anthem.com

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

Medical policy 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

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

Medical policy updates are available on anthem.com

December 2018 Anthem Maine Provider Newsletter Medical Policy & Clinical Guidelines Dec 1, 2018

Medical policy updates are available on anthem.com

August 2018 Anthem Maine Provider Newsletter Medical Policy & Clinical Guidelines Aug 1, 2018

Medical policy updates are available on anthem.com

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

Medical policy updates are available on anthem.com

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

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

June 2018 Maine newsletter Medical Policy & Clinical Guidelines Jun 22, 2018

Medical policy and clinical guideline updates available on our provider website

Notice of material change/amendment to contract.
January 2023 Provider Newsletter - Maine Medical Policy & Clinical Guidelines Dec 30, 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

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

Medical policy and clinical guideline updates available on anthem.com

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

Medical Policy and Clinical Guideline updates are available on our provider website

Notice of material change/amendment to contract.
February 2023 Provider Newsletter - Maine Medical Policy & Clinical Guidelines Feb 1, 2023

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

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

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
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