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

A new facility reimbursement policy titled Treatment Rooms with Office Evaluation and Management Services will be implemented beginning with dates of service on, or after May 1, 2021. Anthem does not allow reimbursement for office evaluation and management services when reported on a CMS 1450 (UB-04) with revenue code 761 (treatment rooms).  Modifiers will not override the edit.

 

For more information about this policy, view Anthem’s reimbursement policies online for your state: Indiana, Kentucky, Missouri, Ohio, Wisconsin.

975-0221-PN-KY.MO