Anthem Provider Communications

Reimbursement policy update: Consultations – Professional*

Jul 1, 2021 • Policy Updates / Reimbursement Policies

*Notice of Material Amendment/Change to Contract (MAC)

Beginning with dates of service on or after October 1, 2021, Anthem Blue Cross and Blue Shield (Anthem)’s current Documentation and Reporting Guidelines for Consultations will be renamed Consultations. This policy aligns with CMS guidance, does not allow reimbursement for inpatient (99251-99255) and outpatient (99241-99245) consultation codes and requires providers to bill the appropriate office visit E/M code for consultation services.

For more information about this policy, visit the reimbursement policy page on anthem.com.

1226-0721-PN-CNT