Medicare Advantage plans under Anthem Blue Cross and Blue Shield follow original Medicare guidelines and billing requirements for partial hospitalization services. The Centers for Medicare & Medicaid Services’ (CMS) regulations (42 CFR 410.43(c)(1)) state that partial hospitalization programs (PHPs) are intended for members who require a minimum of 20 hours per week of therapeutic services as evidenced in their plan of care. All partial hospitalization services require prior authorization. Check out the full article online, partial hospitalization services. 



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May 2019 Anthem Provider Newsletter - Virginia