Reimbursement policy update: Prolonged Services — Professional

Beginning with dates of service on or after October 1, 2023, Empire BlueCross BlueShield will update the Prolonged Services – Professional reimbursement policy as follows:

• Remove language requiring providers to report start and stop times for reimbursement eligibility.
•  Update the Related Coding Section to:  
1. Remove CPT^® codes 99354 – 99357 to align with the 2023 AMA CPT code changes. 
2. Add CPT code 99418 to align with the 2023 AMA CPT code changes.
3. Remove CPT code G2212 and add to the Bundled Services and Supplies - Professional reimbursement policy as not reimbursable.
• Remove the ICD-10-CM code list. 

If you believe a claim reimbursement decision should be reviewed, please follow the normal claims dispute process outlined in the provider manual. 

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