Policy Updates Reimbursement PoliciesCommercialAugust 1, 2024

Reimbursement policy update: Bundled Services and Supplies — Facility

Beginning with dates of service on or after November 1, 2024, Anthem will update the Bundled Services and Supplies — Facility reimbursement policy as follows:

  • Addition of categories of services considered integral to the primary service, or included in the facility fee that are not allowed for separate reimbursement when billed by a facility provider
  • Addition of the following code to the Related Coding section:
    • G2211 — visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed healthcare services and/or with medical care services that are part of ongoing care related to a patient's single, serious condition or a complex condition

For specific policy details, visit the reimbursement policy page and select the appropriate state.

In Missouri (excluding 30 counties in the Kansas City area): Anthem Blue Cross and Blue Shield is the trade name of RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. Independent licensees of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

MULTI-BCBS-CM-062760-24

PUBLICATIONS: August 2024 Provider Newsletter