[California] Service line limits update for Medicare Advantage claims

Effective immediately (June 25, 2026): Billing team must audit all Medicare Advantage claim submission processes to ensure compliance with the 449 service line limit per encounter. (1) Review current billing practices and identify claims that routinely exceed 449 service lines. (2) Update billing software validation rules to flag or reject claims exceeding 449 service lines before submission to Anthem Blue Cross. (3) Implement one or more of the following strategies for affected claims: combine related service lines where clinically appropriate, split outpatient claims by date of service, or submit inpatient claims as interim bills. (4) Train providers and billing staff on the new limit and approved reduction methods. (5) Contact your Anthem Blue Cross provider representative for questions or clarification. Failure to comply will result in claim denials and revenue loss. This applies to all Anthem Blue Cross Medicare Advantage claims submitted from this date forward.