New Reimbursement policy: Diagnostic Radiopharmaceuticals and Contrast Materials — Professional and Facility

Beginning with dates of service on or after October 1, 2024, Anthem will implement a new reimbursement policy titled Diagnostic Radiopharmaceuticals and Contrast Materials — Professional and Facility.

The following statement was removed from the Place of Service — Professional reimbursement policy and added this policy:

• The health plan does not allow separate reimbursement for diagnostic radiopharmaceuticals and contrast materials when billed by professional providers in a facility place of service.

The Related Coding section contains specific codes with guidelines for both professional and facility providers.

Facility providers are not subject to the diagnostic radiopharmaceuticals and contrast materials guidelines within this policy.

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

Through our efforts, we are committed to reducing administrative burden and ensuring timely payments because we value you, our care provider partners.