Coming soon: Reimbursement for select HEDIS-related CPT II codes for Medicare Advantage members
- Billed in the procedure code field in the same way as CPT Category I codes.
- Used to describe clinical components usually included in evaluation, management or clinical services.
- Billed with a $0 billable charge amount since they are not usually associated with any relative value.
Under this new incentive program, Anthem will reimburse contracted Medicare Advantage providers for submitting select HEDIS®-related CPT Category II codes for eligible members.
Using these CPT Category II codes for Medicare Advantage members will:
- Help providers address clinical care opportunities.
- Facilitate timely and accurate claims payments.
Detailed information about this program, including a list of applicable codes, will be sent to providers.
April 2019 Anthem Provider Newsletter - Wisconsin