Guideline Updates Reimbursement PoliciesAnthem Blue Cross and Blue Shield | Medicare AdvantageAugust 1, 2024

Reimbursement policy update: Modifier 78

(Policy G-06016, effective 07/01/2024)

Past system limitations prevented us from reimbursing Modifier 78 in complete alignment with Centers for Medicare & Medicaid Services (CMS). New system updates will now allow Anthem to closer align with the CMS Medicare Physician Fee Schedule Data Base (MPFSDB).

For claims processed on and after 07/01/2024, you may see a slight adjustment in reimbursement which will reflect this configuration update.

For specific policy details visit the reimbursement policy page at anthem.com/medicareprovider.

Anthem Blue Cross and Blue Shield is the trade name of Anthem Health Plans of Virginia, Inc. Anthem Blue Cross and Blue Shield, and its affiliate HealthKeepers, Inc., serving all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123, are independent licensees of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

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PUBLICATIONS: August 2024 Provider Newsletter