Policy Updates Reimbursement PoliciesCommercialSeptember 1, 2023

Reimbursement policy update: Place of Service – Facility

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

Beginning with dates of service on or after December 1, 2023, Empire BlueCross BlueShield will update the Place of Service – Facility reimbursement policy to include professional services billed under revenue codes 960-983 expanded to 960-989. According to the policy, Evaluation & Management (E/M) services and other professional services:

  • Must be billed on a CMS-1500 claim form; and
  • Are not reimbursable if billed on a UB-04 claim form (excluding E/M services rendered in an emergency room and billed with emergency room revenue codes).

The policy will be retitled Facility Guidelines for Claims related to Professional Services – Facility.

For specific policy details, visit the reimbursement policy page at empireblue.com.

NYBCBS-CM-034777-23-CPN34757

PUBLICATIONS: September 2023 Provider Newsletter