Policy Updates Reimbursement PoliciesCommercialApril 1, 2020

REMINDER: Reimbursement Policy - Facility Revenue Code Billing

Beginning with dates of service on or after January 1, 2019, Anthem Blue Cross and Blue Shield (Anthem) requires that facilities billing outpatient services on a UB04 report current and valid CPT or HCPCS codes with revenue codes as specified by the National Uniform Billing Committee (NUBC). Anthem also requires that outpatient facilities report current and valid CPT or HCPCS codes for remaining revenue codes when, and if, appropriate CPT or HCPCS codes are available for the revenue codes being reported.

In addition, Anthem requires that applicable CPT or HCPCS modifiers be reported with the CPT or HCPCS codes to clarify or improve the accuracy of the procedure being reported when appropriate. For more information about this policy, visit the Facility Reimbursement Policy at anthem.com/provider.