[New York] Reimbursement policy update: Screening Services with Related Evaluation and Management Services — Professional

By March 31, 2026: Billing team must update claims submission guidelines and billing system edits to prevent separate billing of screening services, gynecological exams, counseling services, medical nutrition therapy, prolonged services, and visual acuity screenings when billed on the same date as preventive medicine visits (CPT 99381-99387, 99391-99397, G0402). Update encounter forms and provider documentation templates to clarify that Modifier 25 will NOT result in separate reimbursement for these bundled services. Train providers and billing staff that these services are considered integral to preventive medicine visits. Failure to implement these changes will result in claim denials and revenue loss for Anthem commercial members in affected states.