Policy Updates Reimbursement PoliciesCommercialNovember 1, 2024

Reimbursement policy reminder: Multiple Surgery — Facility

As a reminder, and as previously communicated through letters we mailed to participating facilities on October 1, 2021, we allow reimbursement for only the primary or highest-valued procedure when multiple or bilateral procedures are performed on the same day or same session and at the same place of treatment when billed by a facility. A single surgical procedure is subject to multiple procedure reduction guidelines when submitted with multiple units. 

For specific Multiple Surgery — Facility reimbursement policy details, visit the reimbursement policy page.

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PUBLICATIONS: November 2024 Provider Newsletter