Material Changes/Amendments to Contract and Changes to Prior Authorization Requirements may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements starred (*) below.


  • Evaluation and management changes 2021
  • Prior authorization updates for specialty pharmacy are available – January 2021*
  • Medical Policy and Clinical Guideline Updates – January 2021*
  • MCG Care Guidelines 24th Edition Customization*
  • Anthem implements pilot program for in-network skilled nursing facilities (SNF)
  • Reimbursement policy update: Multiple diagnostic imaging procedures – Professional
  • Reimbursement policy update: Frequency Editing – Professional*
  • Reimbursement policy update: Guidelines for Reporting Timed Units for Physical Medicine and Rehabilitation – Professional*
  • Reimbursement policy update: Modifier Rules – Professional*
  • Reimbursement policy update: Unit Frequency Maximum for Drugs and Biologicals – Professional*


Featured In:
January 2021 Anthem Provider News - Ohio