CommercialBilling CodesHigh impact
[Georgia] Reimbursement policy update: Facility Guidelines for Claims Related to Professional Services — Facility
Anthem BCBS·GA·Claims & Billing
Effective date
Oct 1, 2026
We identified it
Jul 2, 2026
Summary
Effective October 1, 2026, Anthem Blue Cross and Blue Shield in Georgia requires that professional services previously billed on UB-04 forms (revenue codes 0920, 0929, 0942) must now be billed by rendering providers on CMS-1500 forms using applicable HCPCS/CPT codes. Claims submitted on UB-04 with these revenue codes will be denied; providers cannot balance bill members for services affected by this change.
Action Required
By September 30, 2026: Billing team must (1) audit all current workflows to identify claims using UB-04 revenue codes 0920, 0929, and 0942; (2) update billing software and templates to route these services to CMS-1500 claim forms instead of UB-04; (3) ensure rendering providers are configured to bill these services with appropriate HCPCS/CPT codes rather than revenue codes; (4) train all billing and clinical staff on the new requirement; (5) establish internal controls to prevent UB-04 submissions with these revenue codes. Failure to implement will result in claim denials for affected services. Verify implementation with test claims before October 1, 2026 effective date.