Material adverse change (MAC)


Beginning with dates of service on or after February 1, 2022, Anthem Blue Cross and Blue Shield (Anthem) will implement a new facility reimbursement policy titled, Multiple and Bilateral Surgery Processing. 


Anthem allows reimbursement for only the primary, or highest valued, procedure when multiple or bilateral procedures are performed on the same day or same session, and at the same place of treatment when billed by a facility. A single surgical procedure is subject to multiple procedure reduction guidelines when submitted with multiple units.


For more information about this policy, visit the Anthem reimbursement policy page at



Featured In:
October 2021 Anthem Provider News - Nevada