Reimbursement policy update: Modifier 66: Surgical Teams - Professional

In the December 2021 edition of Provider News, Anthem Blue Cross and Blue Shield (Anthem) announced that a new commercial reimbursement policy titled Modifier 66 Surgical Teams – Professional would be effective for dates of service on or after March 1, 2022.

 

The effective date of the policy has changed. The policy will now be effective for dates of service on or after November 1, 2022.

 

Under this reimbursement policy, Anthem allows the of procedures eligible for surgical teams when billed with modifier 66. Anthem follows the CMS MPFS Team Surgery payment indicators and will allow services requiring team surgery billed with CMS MPFS payment indicator ‘1’ (sometimes) and ‘2’ (always) and will deny services billed with the indicator ‘0’ (never) and ‘9’ (not applicable).

 

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

 

MULTI-BCBS-CM-004854-22