Medicare AdvantageApril 30, 2019
Partial hospitalization services
Beginning January 1, 2024, Empire became Anthem. This article, published under the former brand, now applies to Anthem.
Medicare Advantage plans under Empire BlueCross BlueShield follow original Medicare guidelines and billing requirements for partial hospitalization services. CMS regulations (42 CFR 410.43(c)(1)) state that partial hospitalization programs (PHPs) are intended for members who require a minimum of 20 hours per week of therapeutic services as evidenced in their plan of care. All partial hospitalization services require prior authorization. Read more.
PUBLICATIONS: May 2019 Empire Provider Newsletter
To view this article online:
Visit https://providernews.anthem.com/new-york/articles/medical-records-request-for-risk-adjustment-1-2255
Or scan this QR code with your phone