Anthem Posts Bundled Services and Frequency Editing Reimbursement Policies Updates

August 2019 ~

Anthem has announced upcoming updates to its Bundled Services and Supplies and Frequency Editing reimbursement policies.

Beginning with dates of service on or after November 1, 2019, new Interprofessional CPT® codes 99451 and 99452 are not eligible for reimbursement when reported with another service or reported as a stand-alone service.

According to the insurer, these codes have been added to policy section 1 of the Bundled Services and Supplies reimbursement policy.

Additionally, Aetna released the upcoming change to its Frequency Editing Reimbursement policy. The 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.


CPT® is a registered trademark of the American Medical Association.



Source(s): August 2019 Anthem Provider News;