Reimbursement policy update: Nurse Practitioner and Physician Assistant Services

Beginning with dates of service on or after February 1, 2025, Anthem will update the Nurse Practitioner and Physician Assistant Services — Professional reimbursement policy as indicated below.

The following services will be removed from the policy and are eligible for a payment reduction when billed by a nurse practitioner (NP) or physician assistant (PA) provider:

• Preventive Services
• Radiology Services

The following services will be added to the policy and will not be considered for a payment reduction when billed by a nurse practitioner (NP) or physician assistant (PA) provider:

• Drugs
• Durable Medical Equipment, Prosthetics, Orthotics and Supplies
• Laboratory Services and Laboratory Screening Tests

For specific policy details, visit the reimbursement policy page by selecting here.