Reimbursement Policy Update: Frequency Editing-Professional*

Our Frequency Editing policy applies frequency maximums per day and/or per date span within the same grouping which may be based on the CMS’s MUEs, industry standards, and/or code description.  Beginning with dates of service November 1, 2019, maximum units per day may be based on claims data analysis.

 

View reimbursement policies online at anthem.com

To find Anthem’s professional and facility reimbursement policies online, select your state: Indiana, Kentucky, Missouri, Ohio, Wisconsin.

 

^{* Notice of Material Changes/Amendments to Contract and Changes to Prior Authorization Requirements may apply for new or updated reimbursement policies, medical policies, or prior authorization requirements.}