Policy Updates Reimbursement PoliciesMedicare AdvantageAugust 1, 2024

Reimbursement policy update: Nurse Practitioner and Physician Assistant Services

(Policy G-20002, effective 11/01/2024)

Beginning with dates of service on or after 11/01/2024, Anthem will update the Nurse Practitioner and Physician Assistant Services reimbursement policy as indicated below.

The following services will be removed as physicians’ services:

    • Preventive Services
    • Radiology Services

The following services will be included as physicians’ services:

    • Durable Medical Equipment Prosthetics, Orthotics, and Supplies (DMEPOS)
    • Laboratory Services and Screening Services

For specific policy details, visit the reimbursement policy page at 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.

MULTI-BCBS-CR-050463-24-CPN49984

PUBLICATIONS: August 2024 Provider Newsletter