Products & Programs Long-Term Services & SupportsHealthKeepers, Inc. | Anthem HealthKeepers Plus Medicaid productsApril 1, 2024

Changes to prior authorization requirements for routine visit billing code 99509

Effective since December 1, 2023, Consumer Directed Service Facilitators are no longer required to submit prior authorizations for routine visit billing code 99509. There is a benefit limit of 1 unit/visit per month with a maximum of 10 units/visits per year.

Providers with questions about this billing guidance may reach out via email to VALTSSPR@Anthem.com or contact 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.

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PUBLICATIONS: April 2024 Provider Newsletter