Policy Updates Reimbursement PoliciesCommercialAugust 1, 2023

New reimbursement policy: Split Care Surgical Modifiers — Professional

Beginning January 1, 2024, Empire became Anthem. This article, published under the former brand, now applies to Anthem.

Effective June 14, 2023, Empire BlueCross BlueShield’s split care surgical modifier language was removed from the Global Surgical Package — Professional reimbursement policy and added to a new standalone reimbursement policy titled Split Care Surgical Modifiers — Professional. This policy allows reimbursement based on a percentage of the fee schedule or contracted/negotiated rate for the surgical procedure. The percentage is determined by the modifier that is appended to the procedure code. The Related Coding section of the policy identifies the applicable modifiers and standard reimbursement percentages.

For specific policy details, visit the reimbursement policy page.

NYBCBS-CM-030757-23

PUBLICATIONS: August 2023 Provider Newsletter