Reimbursement policy update: Place of Service - Facility*

*Notice of Material Amendment/Change to Contract (MAC)

Beginning with dates of service on or after October 1, 2022, Anthem Blue Cross and Blue Shield will update the policy language to indicate the following:

• The title of the policy will be renamed to Place of Service – Facility from Place of Service Evaluation and Management Services – Facility.
• Professional services billed under revenue codes 960-983 are non-reimbursable when submitted on a UB-04.
• Preventive Counseling CPTs 99406–99409, 99411, and 99412 are non-reimbursable when billed in an outpatient setting.

 

As a reminder, Evaluation and Management (E/M) services and professional services (excluding evaluation and management services rendered in the emergency room and billed with ER revenue codes) are required to be billed on a CMS 1500 form.

 

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

 

MULTI-BCBS-COMM-001884-22