CommercialMay 1, 2021
Reimbursement policy update: Frequency editing (Professional)
Beginning January 1, 2024, Empire became Anthem. This article, published under the former brand, now applies to Anthem.
In the January 2021 edition of Provider News, we shared information regarding changes to the Frequency Editing Professional Reimbursement Policy. The notice indicated that constant attendance, timed modalities for physical therapy, occupational therapy or speech therapy are limited to 4 Units or 1 hour per date of service for the same member, by the same provider, per therapy type for (97110 – 97124, 97129, 97130, 97140, 97533 – 97542, 97760 – 97763). Upon further review, we have reconsidered our position and have removed this edit for dates of service on or after April 1, 2021.
PUBLICATIONS: May 2021 Newsletter
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