Policy Updates Reimbursement PoliciesCommercialNovember 1, 2024

Reimbursement policy update: Nurse Practitioner and Physician Assistant Services

Beginning with dates of service on or after February 1, 2025, Anthem will update the Nurse Practitioner and Physician Assistant Services — Professional reimbursement policy as indicated below.

The following services will be removed from the policy and are eligible for a payment reduction when billed by a nurse practitioner (NP) or physician assistant (PA) provider:

  • Preventive Services
  • Radiology Services

The following services will be added to the policy and will not be considered for a payment reduction when billed by a nurse practitioner (NP) or physician assistant (PA) provider:

  • Drugs
  • Durable Medical Equipment, Prosthetics, Orthotics and Supplies
  • Laboratory Services and Laboratory Screening Tests

For specific policy details, visit the reimbursement policy page by selecting here.

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-CM-069779-24

PUBLICATIONS: November 2024 Provider Newsletter