Reimbursement policy retirement: Acupuncture Billed with Evaluation and Management - Professional
Anthem will enforce the requirements set forth in applicable CPT® guidelines. As always, Anthem reserves the right to request medical records when needed to validate appropriate billing.
For specific policy details, visit the reimbursement policy page at anthem.com provider website.
December 2022 Anthem Provider News - Wisconsin
Effective January 1, 2023, Anthem Blue Cross and Blue Shield’s (Anthem) Acupuncture Billed with Evaluation and Management - Professional policy will be retired. The policy aligns with standard correct coding requirements, as outlined in applicable CPT guidelines, which provide that Evaluation and Management services may be reported separately from acupuncture services by using modifier 25 when appropriate. Since the policy does not deviate from this guidance, the policy will be retired.