Ohio
Provider Communications

Articles Category: Policy Updates / Reimbursement Policies

Title Publication Category Date

Reimbursement policy update: Modifiers 25 and 57 - Professional

March 2023 Anthem Provider News - Ohio Reimbursement Policies Mar 1, 2023

Outpatient facility revenue code billing requirements

January 2023 Anthem Provider News - Ohio Reimbursement Policies Dec 30, 2022

Reimbursement policy update: Multiple Surgery - Facility

December 2022 Anthem Provider News - Ohio Reimbursement Policies Dec 1, 2022

Reimbursement policy update: Bundled Services and Supplies - Professional*

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

December 2022 Anthem Provider News - Ohio Reimbursement Policies Dec 1, 2022

Reimbursement policy update: Treatment Rooms with Office Evaluation and Management Services - Facility*

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

December 2022 Anthem Provider News - Ohio Reimbursement Policies Dec 1, 2022

Correction to reimbursement policy: Place of Service - Facility

Notice of Material Amendment/Change to Contract (MAC)

November 2022 Anthem Provider News - Ohio Reimbursement Policies Nov 1, 2022

Reimbursement policy update: Three-Dimensional (3D) Radiology Services - Professional and Facility

October 2022 Anthem Provider News - Ohio Reimbursement Policies Oct 1, 2022

Reimbursement policy update: Multiple and Bilateral Surgery Processing - Professional

Notice of Material Amendment/Change to Contract (MAC)
October 2022 Anthem Provider News - Ohio Reimbursement Policies Oct 1, 2022

Reimbursement policy update: Modifier Rules - Professional*

*Notice of Material Amendment/Change to Contract (MAC)
September 2022 Anthem Provider News - Ohio Reimbursement Policies Sep 1, 2022

Reimbursement policy update: Assistant at Surgery (Modifiers 80, 81, 82, AS) - Professional

September 2022 Anthem Provider News - Ohio Reimbursement Policies Sep 1, 2022

Reimbursement policy update: Modifier 66: Surgical Teams - Professional

September 2022 Anthem Provider News - Ohio Reimbursement Policies Sep 1, 2022

New reimbursement policy: Transitional Care Management - professional

July 2022 Anthem Provider News - Ohio Reimbursement Policies Jul 1, 2022

New reimbursement policy: Modifier FB - Professional and Facility*

*Notice of Material Amendment/Change to Contract (MAC)
July 2022 Anthem Provider News - Ohio Reimbursement Policies Jul 1, 2022

Reimbursement policy update: Modifier Rules - Professional*

*Notice of Material Amendment/Change to Contract (MAC)
July 2022 Anthem Provider News - Ohio Reimbursement Policies Jul 1, 2022

Reimbursement policy update: Laboratory and venipuncture services - professional and facility*

*Notice of Material Amendment/Change to Contract (MAC)
July 2022 Anthem Provider News - Ohio Reimbursement Policies Jul 1, 2022

Reimbursement policy update: Place of Service - Facility*

*Notice of Material Amendment/Change to Contract (MAC)
July 2022 Anthem Provider News - Ohio Reimbursement Policies Jul 1, 2022

Retraction for reimbursement policy: Sexually Transmitted Infections - Professional

July 2022 Anthem Provider News - Ohio Reimbursement Policies Jul 1, 2022

Reimbursement policy update: Distinct Procedural Service, Modifiers 59, XE, XP, XS, XU - professional*

*Notice of Material Amendment/Change to Contract (MAC)
July 2022 Anthem Provider News - Ohio Reimbursement Policies Jul 1, 2022

Reimbursement policy update: Treatment Rooms with Office Evaluation and Management Services - Facility*

*Notice of Material Amendment/Change to Contract (MAC)
June 2022 Anthem Provider News - Ohio Reimbursement Policies Jun 1, 2022

RETRACTION: Inpatient Facility Transfers - facility reimbursement policy

December 2021 Anthem Provider News - Ohio Reimbursement Policies Dec 1, 2021

Reimbursement policy update: Assistant at Surgery (Modifiers 80, 81, 82, AS) - Professional*

*Notice of Material Amendment/Change to Contract (MAC)
December 2021 Anthem Provider News - Ohio Reimbursement Policies Dec 1, 2021

New reimbursement policy update: Modifier 62: Co-Surgeon Services and Modifier 66: Surgical Teams - Professional*

*Notice of Material Amendment/Change to Contract (MAC)
December 2021 Anthem Provider News - Ohio Reimbursement Policies Dec 1, 2021

Reimbursement policy update: Virtual Visits - Professional and Facility

December 2021 Anthem Provider News - Ohio Reimbursement Policies Dec 1, 2021

Clarification to reimbursement policy updates: Modifier Rules and Guidelines for Reporting Timed Units for Physical Medicine and Rehabilitation - professional

November 2021 Anthem Provider News - Ohio Reimbursement Policies Nov 1, 2021

New reimbursement policy: Multiple and Bilateral Surgery Processing - Facility*

*Notice of Material Amendment/Change to Contract (MAC)
October 2021 Anthem Provider News - Ohio Reimbursement Policies Oct 1, 2021

Reimbursement policy clarification: Claims requiring additional documentation - Facility

October 2021 Anthem Provider News - Ohio Reimbursement Policies Oct 1, 2021

Reimbursement policy update: Sexually transmitted infections testing - Professional*

*Notice of Material Amendment/Change to Contract (MAC)
September 2021 Anthem Provider News - Ohio Reimbursement Policies Sep 1, 2021

New reimbursement policy update: Inpatient Facility Transfers - Facility* - RETRACTION

*Notice of Material Amendment/Change to Contract (MAC)
September 2021 Anthem Provider News - Ohio Reimbursement Policies Sep 1, 2021

Reimbursement policy update: Drug Screen Testing - Professional*

*Notice of Material Amendment/Change to Contract (MAC)
September 2021 Anthem Provider News - Ohio Reimbursement Policies Sep 1, 2021

Reimbursement policy update: Virtual Visits (Professional and Facility)*

*Notice of Material Amendment/Change to Contract (MAC)
August 2021 Anthem Provider News - Ohio Reimbursement Policies Aug 1, 2021

Reimbursement policy update: Claims requiring additional documentation (Facility)*

*Notice of Material Amendment/Change to Contract (MAC)
August 2021 Anthem Provider News - Ohio Reimbursement Policies Aug 1, 2021

Reimbursement policy update: Distinct Procedural Service, Modifiers 59 and XE, XP, XS, & XU*

*Notice of Material Amendment/Change to Contract (MAC)
August 2021 Anthem Provider News - Ohio Reimbursement Policies Aug 1, 2021

New reimbursement policy: Non-patient laboratory services - Facility*

*Notice of Material Amendment/Change to Contract (MAC)
July 2021 Anthem Provider News - Ohio Reimbursement Policies Jul 1, 2021

Reimbursement policy update: Consultations - Professional*

*Notice of Material Amendment/Change to Contract (MAC)
July 2021 Anthem Provider News - Ohio Reimbursement Policies Jul 1, 2021

Update to evaluation and management services correct coding - Professional

June 2021 Anthem Provider News - Ohio Reimbursement Policies Jun 1, 2021

Reimbursement policy update: Outpatient facility claim edits

June 2021 Anthem Provider News - Ohio Reimbursement Policies Jun 1, 2021

Reimbursement policy update: Claims Requiring Additional Documentation - Facility*

*Notice of Material Amendment/Change to Contract (MAC)
May 2021 Anthem Provider News - Ohio Reimbursement Policies May 1, 2021

Reimbursement policy reminder: Readmission - Facility

May 2021 Anthem Provider News - Ohio Reimbursement Policies May 1, 2021

Reimbursement policy update: Frequency editing - Professional

May 2021 Anthem Provider News - Ohio Reimbursement Policies May 1, 2021

New reimbursement policy: Newborn Inpatient Stays for facilities*

*Notice of Material Amendment/Change to Contract (MAC)
April 2021 Anthem Provider News - Ohio Reimbursement Policies Apr 1, 2021

Claims editing update for ICD-10-CM Excludes 1 notes

March 2021 Anthem Provider News - Ohio Reimbursement Policies Mar 1, 2021

Reimbursement policy update: Emergency Room Transfers - Facility*

February 2021 Anthem Provider News - Ohio Reimbursement Policies Feb 1, 2021

Reimbursement policy update: Treatment Rooms with Office Evaluation and Management Services - Facility*

February 2021 Anthem Provider News - Ohio Reimbursement Policies Feb 1, 2021

Reimbursement policy update: Multiple diagnostic imaging procedures - Professional*

January 2021 Anthem Provider News - Ohio Reimbursement Policies Jan 1, 2021

Reimbursement policy update: Frequency editing - Professional*

January 2021 Anthem Provider News - Ohio Reimbursement Policies Jan 1, 2021

Reimbursement policy update: Guidelines for reporting timed units for physical medicine and rehabilitation - Professional*

January 2021 Anthem Provider News - Ohio Reimbursement Policies Jan 1, 2021

Reimbursement policy update: Modifier Rules - Professional*

January 2021 Anthem Provider News - Ohio Reimbursement Policies Jan 1, 2021

Reimbursement policy update: Unit frequency maximum for drugs and biologicals - Professional*

January 2021 Anthem Provider News - Ohio Reimbursement Policies Jan 1, 2021

Reimbursement policy update: Bundled services and supplies (Professional)*

December 2020 Anthem Provider News - Ohio Reimbursement Policies Dec 1, 2020

New reimbursement policy: Documentation standards for episodes of care (Professional)*

November 2020 Anthem Provider News - Ohio Reimbursement Policies Nov 1, 2020

Reimbursement policy update: Modifier rules (Professional)*

November 2020 Anthem Provider News - Ohio Reimbursement Policies Nov 1, 2020

Reimbursement policy update: Bundled services and supplies (Professional)*

November 2020 Anthem Provider News - Ohio Reimbursement Policies Nov 1, 2020

Reimbursement policy update: Multiple diagnostic imaging facility (Facility)*

November 2020 Anthem Provider News - Ohio Reimbursement Policies Nov 1, 2020

Reimbursement policy update: Emergency department - leveling of Evaluation and Management services (Facility)*

October 2020 Anthem Provider News - Ohio Reimbursement Policies Oct 1, 2020

Reimbursement policy update: Claims requiring additional documentation policy (Facility)

October 2020 Anthem Provider News - Ohio Reimbursement Policies Oct 1, 2020

Reimbursement policy update: Laboratory and venipuncture (Professional)*

October 2020 Anthem Provider News - Ohio Reimbursement Policies Oct 1, 2020

Reimbursement policy update: Distinct Procedural Services- Modifiers 59, XE, XP, XS, XU (Professional)*

September 2020 Anthem Provider News - Ohio Reimbursement Policies Sep 1, 2020

Reimbursement policy update: Frequency Editing (Professional)*

September 2020 Anthem Provider News - Ohio Reimbursement Policies Sep 1, 2020

Reimbursement Policy Update: Claims requiring additional documentation (Facility)*

August 2020 Anthem Provider News - Ohio Reimbursement Policies Aug 1, 2020

New Reimbursement Policies: Nurse Practitioner and Physician Assistant Services (Professional)*

June 2020 Anthem Provider News - Ohio Reimbursement Policies Jun 1, 2020

Reimbursement Policy Update: Claims requiring additional documentation (Facility)*

May 2020 Anthem Provider News - Ohio Reimbursement Policies May 1, 2020

Reminder about system updates

May 2020 Anthem Provider News - Ohio Reimbursement Policies May 1, 2020

Outpatient Facility Edit Implementation*

January 2020 Anthem Provider News - Ohio Reimbursement Policies Jan 1, 2020

New Reimbursement Policies: Durable Medical Equipment, Rent to Purchase Durable Medical Equipment, and Modifiers (Professional)

December 2019 Anthem Provider News - Ohio Reimbursement Policies Dec 1, 2019

System updates for 2020 (Professional)

December 2019 Anthem Provider News - Ohio Reimbursement Policies Dec 1, 2019

Reimbursement Policy update: Place of Service-Professional*

October 2019 Anthem Provider News - Ohio Reimbursement Policies Oct 1, 2019

New Reimbursement Policies: Maternity Services and Multiple Delivery - Professional*

September 2019 Anthem Provider News - Ohio Reimbursement Policies Sep 1, 2019

New Reimbursement Policy: Intensity Modulated Radiation Therapy Planning and Delivery - Professional*

September 2019 Anthem Provider News - Ohio Reimbursement Policies Sep 1, 2019

Claim editing update for Excludes1 notes

September 2019 Anthem Provider News - Ohio Reimbursement Policies Sep 1, 2019

Reimbursement Policy Update: Bundled Services-Professional*

August 2019 Anthem Provider News - Ohio Reimbursement Policies Aug 1, 2019

Reimbursement Policy Update: Frequency Editing-Professional*

August 2019 Anthem Provider News - Ohio Reimbursement Policies Aug 1, 2019

Clinical Validation: Professional*

July 2019 Anthem Provider News - Ohio Reimbursement Policies Jul 1, 2019

Modifier 79 reminder: Professional

July 2019 Anthem Provider News - Ohio Reimbursement Policies Jul 1, 2019

Modifier 63 reminder: Professional

July 2019 Anthem Provider News - Ohio Reimbursement Policies Jul 1, 2019

ICD-10-CM Coding Guidelines and Laterality: Professional

July 2019 Anthem Provider News - Ohio Reimbursement Policies Jul 1, 2019

New Reimbursement Policy: Ambulance Transportation -- Professional*

June 2019 Anthem Provider Newsletter - Ohio Reimbursement Policies Jun 1, 2019

Reimbursement Policy Update: Frequency Editing -- Professional*

June 2019 Anthem Provider Newsletter - Ohio Reimbursement Policies Jun 1, 2019

Update: Drug Screen Testing - Professional*

May 2019 Anthem Provider Newsletter - Ohio Reimbursement Policies May 1, 2019

New Reimbursement Policy: Partial Hospitalization Program and Intensive Outpatient Program Services Facility*

April 2019 Anthem Provider Newsletter - Ohio Reimbursement Policies Apr 1, 2019

Reimbursement Policy Updates: February 2019*

February 2019 Anthem Ohio Provider Newsletter Reimbursement Policies Feb 1, 2019

Reimbursement Policy Update: Injectable Substances with Related Injection Services - Professional*

February 2019 Anthem Ohio Provider Newsletter Reimbursement Policies Feb 1, 2019

View reimbursement policies online at anthem.com

December 2018 Anthem Ohio Provider Newsletter Reimbursement Policies Dec 1, 2018

Reimbursement Policy Updates - December 2018

December 2018 Anthem Ohio Provider Newsletter Reimbursement Policies Dec 1, 2018

Reimbursement Policy Update - Scope of License (Professional)

December 2018 Anthem Ohio Provider Newsletter Reimbursement Policies Dec 1, 2018

New Reimbursement Policy - Facility Revenue Code Billing

October 2018 Anthem Ohio Provider Newsletter Reimbursement Policies Sep 28, 2018

Reimbursement Policy Update - Readmissions (Facility)

October 2018 Anthem Ohio Provider Newsletter Reimbursement Policies Sep 28, 2018

View reimbursement policies online at anthem.com

October 2018 Anthem Ohio Provider Newsletter Reimbursement Policies Sep 28, 2018
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