(Policy 06-0149, effective 11/30/19)


Currently, Anthem Blue Cross and Blue Shield includes Early and Periodic Screening, Diagnosis and Treatment (EPSDT) component services in the reimbursement of preventive medicine evaluation and management (E&M) visits unless they are appended with Modifier 25 to indicate a significant, separately identifiable E&M service by the same physician on the same date of service.


However, effective November 30, 2019, the following EPSDT component services will be separately reimbursable from preventive medicine E&M visits:

  • Hearing screening with or without the use of an audiometer or other electronic device
  • Vision screening


For additional information, refer to the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) reimbursement policy at https://mediproviders.anthem.com/wi.

Featured In:
October 2019 Anthem Provider News - Wisconsin