Policy Updates Reimbursement PoliciesCommercialJuly 1, 2024

New reimbursement policy: Multiple Surgery — Facility

Beginning with dates of service on or after October 1, 2024, Anthem will implement a new reimbursement policy titled Multiple Surgery — Facility.

This policy indicates that Anthem reimburses surgeries at 100/50/50 when multiple procedures are performed on the same day or same session, and at the same place of treatment. Reimbursement is the total of 100% of the fee schedule or contracted/negotiated rate for the highest valued procedure, 50% for the secondary through 5th procedures, and 50% for the 6th and additional procedure.

For specific policy details, visit the Wisconsin reimbursement policy page anthem.com/provider/policies/reimbursement or anthem.com/provider.

Anthem Blue Cross and Blue Shield is the trade name of Blue Cross Blue Shield of Wisconsin (BCBSWI), Compcare Health Services Insurance Corporation (Compcare), and Wisconsin Collaborative Insurance Company (WCIC). BCBSWI underwrites or administers PPO and indemnity policies and underwrites the out of network benefits in POS policies offered by Compcare or WCIC; Compcare underwrites or administers HMO or POS policies; WCIC underwrites or administers Well Priority HMO or POS policies. Independent licensee(s) of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

WIBCBS-CM-061090-24

PUBLICATIONS: July 2024 Provider Newsletter