Policy Updates Reimbursement PoliciesCommercialNovember 1, 2024

Reimbursement policy update: Nurse Practitioner and Physician Assistant Services

Beginning with dates of service on or after February 1, 2025, Anthem will update the Nurse Practitioner and Physician Assistant Services — Professional reimbursement policy as indicated below.

The following services will be removed from the policy and are eligible for a payment reduction when billed by a nurse practitioner (NP) or physician assistant (PA) provider:

  • Preventive Services
  • Radiology Services

The following services will be added to the policy and will not be considered for a payment reduction when billed by a nurse practitioner (NP) or physician assistant (PA) provider:

  • Drugs
  • Durable Medical Equipment, Prosthetics, Orthotics and Supplies
  • Laboratory Services and Laboratory Screening Tests

For specific policy details, visit the reimbursement policy page by selecting here.

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-069779-24

PUBLICATIONS: November 2024 Provider Newsletter