Reimbursement policy update: Place of Service - Facility

Beginning with dates of service on or after October 1, 2022, Anthem will update the policy language to indicate the following:

• The title of the policy will be renamed to ‘Place of Service – Facility’ from ‘Place of Service Evaluation and Management Services – Facility’.
• Professional services billed under revenue codes 960-983 are nonreimbursable when submitted on a UB-04.
• Preventive counseling CPT codes 99406–99409, 99411, and 99412 are nonreimburseable when billed in an outpatient setting.

 

As a reminder, evaluation and management (E/M) services and other professional services (excluding E/M services rendered in the emergency room and billed with ER revenue codes) are required to be billed on a CMS 1500 form.

 

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

 

MULTI-BCBS-COMM-001884-22