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Anthem BCBSCommercial · Administrative · Claims & Billing · GA, CT, IN, KY, MO, NV, NH, NY, OH · Sleep Medicine, PulmonologyHigh impact

[Georgia] Reimbursement policy update: Sleep Studies and Related Bundled Services and Supplies — Professional

Act
by Oct 31, 2026
Effective date
Nov 1, 2026
Identified
Aug 3, 2026

Summary

Effective November 1, 2026, Anthem Blue Cross and Blue Shield is changing how unattended and home sleep studies must be billed. These services must now be billed as professional services on CMS-1500 forms only—they are no longer eligible for reimbursement when billed on UB-04 facility claim forms. Billing teams must ensure sleep study claims are submitted on the correct form type or face denial.

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What to do

by Oct 31, 2026 · 9 steps
01Billing team must implement the following changes for all Anthem Blue Cross and Blue Shield commercial plans in Georgia and applicable states.
02Update billing software to route unattended and home sleep study claims exclusively to CMS-1500 professional claim forms.
03Remove or disable the ability to bill sleep studies on UB-04 facility forms for these payers.
04Train all billing and coding staff on the new form requirements.
05Update billing guides and internal documentation.
06Audit any pending sleep study claims to ensure correct form type is used.
07Audit claims submitted 30 days prior to effective date to identify any that were billed incorrectly on UB-04 forms and consider resubmission on CMS-1500.
08Failure to comply will result in claim denials.
09Providers are prohibited from balance-billing members due to this policy change.

Original notice

[Georgia] Reimbursement policy update: Sleep Studies and Related Bundled Services and Supplies — Professional
providernews.anthem.com · Always check the source before changing claims.
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Related changes

See all Anthem BCBS changes →
[Ohio] Reimbursement policy update: Sleep Studies and Related Bundled Services and Supplies — ProfessionalHighEffective Nov 1, 2026 · Claims & Billing[New York] Reimbursement policy update: Sleep Studies and Related Bundled Services and Supplies — ProfessionalHighEffective Nov 1, 2026 · Claims & BillingBrowse every Anthem BCBS change in the policy list

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