CommercialReimbursementMedium impact
[New York] Reimbursement policy reminder: Bundled Services and Supplies — Facility
Anthem BCBS·CO, CT, GA, IN, KY, ME, MO, NV, NH, NY, OH, WI·Claims & Billing
Effective date
Jul 1, 2026
We identified it
Jul 2, 2026
Summary
Anthem Blue Cross and Blue Shield is reminding providers in 12 states (including New York) that the Bundled Services and Supplies — Facility reimbursement policy applies to both inpatient and outpatient facility fees effective July 1, 2026. Providers are prohibited from balance-billing members based on this policy, and must review specific policy details on the provider website to ensure proper billing compliance.
Action Required
By June 30, 2026: Billing team must review the complete Bundled Services and Supplies — Facility reimbursement policy on the Anthem provider website (https://providernews.anthem.com/new-york/articles/reimbursement-policy-reminder-bundled-services-and-supplies-30569) to identify which facility services and supplies are bundled. Update billing software and encounter templates to ensure: (1) bundled services and supplies are not billed separately for facility fees in both inpatient and outpatient settings, (2) no balance-billing occurs to members for bundled items, and (3) claims are submitted in compliance with bundling rules. Train billing staff on the specific bundled codes and services affected. Failure to comply may result in claim denials and compliance violations.