November 1, 2011, we’ve offered our participating providers additional reimbursements for ensuring our members receive quality postpartum care.
How does the program work?
We will reimburse the CPT® Category II (CPT II) code 0503F for a postpartum care visit only when billed in conjunction with the CPT code for the postpartum visit. This code will help with HEDIS® data collection.
An example of billing for postpartum care:
The member has a vaginal delivery on January 1, 2018, so bill CPT code 59400 for vaginal delivery global care. On February 1, 2018, the member has a postpartum visit. For this visit, bill 0503F (postpartum care visit). In this scenario, you would be reimbursed the global maternity care fee plus $20 for submitting the claim for the postpartum visit.
To earn the additional $20 postpartum care reimbursement:
- Complete a postpartum visit between 7 and 84 days after delivery.
- Bill using the appropriate delivery code with your patient’s date of delivery (be sure not to bill using the date of admission or date of discharge).
- Submit your claim with the CPT II code 0503F.
If you have any questions about this program, please contact your local Provider Relations representative. Thank you for participating in our network and for working with us to improve the health and clinical outcomes for our members.
Anthem Blue Cross and Blue Shield Healthcare Solutions
HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA).
May 2020 Anthem Provider News and Important Updates -- Nevada