Policy Updates Reimbursement PoliciesCommercialMay 1, 2023

New Reimbursement policy: Bundled Supplies and Services - Facility (MAC)

Material adverse change

Beginning with dates of service on or after August 1, 2023, Anthem Blue Cross and Blue Shield will implement a new facility reimbursement policy titled Bundled Supplies and Services – Facility. This policy identifies certain services and/or supplies ineligible for separate reimbursement when reported by a facility. These identified services and/or supplies are an integral component to the overall procedure.

The Related Coding section of the policy lists and describes the Current Procedural Terminology (CPT®) and Healthcare Common Procedural Coding System (HCPCS Level II) codes that are considered always bundled and not eligible for reimbursement when they are reported as a stand-alone service, or with another service. No modifiers will override the denial for the always bundled services and/or supplies.

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

MULTI-BCBS-CM-022955-23-CPN22784

PUBLICATIONS: May 2023 Provider News