AdministrativeHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsNovember 8, 2023

Billing change for live-in caregivers

Please note, this communication applies to Anthem HealthKeepers Plus Medicaid products offered by HealthKeepers, Inc.

Effective January 1, 2024, billing for live-in caregivers will require the addition of a modifier. Live-in caregivers are exempt from the requirement to use electronic visit verification (EVV). However, providers should ensure that the UB modifier is used when billing codes T1019 or T1005 for a live-in caregiver. Personal care claims that do not include this modifier that are not billed through EVV will be denied.

Additionally, live-in caregivers who provide services during multiple shifts on the same day should also include modifier 76. If multiple claims or service lines are received for the same date of service without the UB 76 modifier combination, the claim will be denied.

Providers with questions about this billing guidance may reach out via email to VALTSSPR@anthem.com or reach out to their regional provider relationship management representative.

If you have any questions about this communication, call Anthem HealthKeepers Plus Provider Services at 800-901-0020.

HealthKeepers, Inc. is an independent licensee of the Blue Cross Blue Shield Association. Anthem HealthKeepers Plus, offered by HealthKeepers, Inc., is a health plan that contracts with the Virginia Department of Medical Assistance Services to provide Medicaid benefits to enrollees. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

VABCBS-CD-042008-23