Quality ManagementMedicare AdvantageMarch 5, 2024

Medication reconciliation post inpatient discharge

Anthem reimburses providers for Medicare Advantage members.

Currently, Anthem reimburses providers $25 for medication reconciliation within 31 days of inpatient discharge for Medicare Advantage members (where the discharge date is day #1) to receive reimbursement for medication reconciliation; documentation must be:

  • Conducted by clinician: MD, DO, PA, NP, RN, or clinical pharmacist.
  • Notated in chart the inpatient stay, admission, hospitalization, or name of the facility.
  • Billed with CPT® code 1111F.

Please note a face-to-face or telehealth visit is not required.

Refer to attachment to view full details

Medicare services provided by Anthem Blue Cross and Blue Shield, trade name of Anthem HealthChoice HMO, Inc. and Anthem HealthChoice Assurance, Inc., Anthem Blue Cross and Blue Shield HP, trade name of Anthem HP, LLC., or Anthem Blue Cross and Blue Shield Retiree Solutions, trade name of Anthem Insurance Companies, Inc.
Independent licensees of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

NYBCBS-CR-051812-24-CPN51690

ATTACHMENTS: Medication reconciliation post inpatient discharge (pdf - 0.73mb)