Reimbursement policy update: Robotic Assisted Surgery – Professional

Beginning with dates of service on or after August 1, 2023, Anthem Blue Cross and Blue Shield’s Robotic Assisted Surgery – Professional reimbursement policy will expand to include CPT^® codes for computer-assisted surgical systems.

This policy does not allow separate reimbursement for technology assisted services detailed in the Related Coding section. These services are considered integral to the primary surgical procedure, are included in the primary surgical procedure, and are not separately reimbursed.

The Related Coding section of the policy has been updated to include the following computer assisted surgical musculoskeletal navigation procedures:

• 0054T: Computer-assisted musculoskeletal surgical navigational orthopedic procedure, with image-guidance based on fluoroscopic images (List separately in addition to code for primary procedure)
• 0055T: Computer-assisted musculoskeletal surgical navigational orthopedic procedure, with image-guidance based on CT/MRI images (List separately in addition to code for primary procedure)
• 20985: Computer-assisted surgical navigational procedure for musculoskeletal procedures, image-less (List separately in addition to code for primary procedure)

The policy has been renamed to Technology Assisted Surgical Procedures – Professional and Facility, which defines both robotic assisted and computer assisted techniques.

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