CommercialAdministrativeLow impact
[California] Direct HMO renamed Independent FFS Physicians: What you need to know
Anthem BCBS·CA·Provider Bulletin
Effective date
Jan 1, 2026
We identified it
Jun 1, 2026
Summary
Effective January 1, 2026, Anthem Blue Cross renamed the 'Direct HMO' provider option to 'Independent FFS Physicians' in California. This is a name-only change with no impact on billing methodology, fee schedules, or network participation. Billing continues on an FFS basis using current PPO fee schedules, and referral requirements remain unchanged.
Action Required
By December 31, 2025: Billing team must update internal systems, templates, and communication materials to reference 'Independent FFS Physicians' instead of 'Direct HMO' for Anthem California commercial plans. No changes to billing logic, referral processes, or reimbursement are required. Staff should note that members selecting a PCP will now see 'Independent FFS Physicians' as the option name. For contract questions, contact specialnetworkreq@anthem.com with subject line 'Independent FFS Physicians.'