CommercialMay 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
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