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[California] Blood Product Administration services will no longer be billed separately
Act
by Nov 30, 2026
Effective date
Dec 1, 2026
Identified
Aug 27, 2026
Summary
Effective December 1, 2026, Anthem Blue Cross Medi-Cal will no longer allow separate billing for Blood Product Administration services in Emergency Room, Clinic, and Treatment/Observation Room encounters. These services must now be included in the facility encounter reimbursement rather than billed as standalone line items. No change to benefits or covered services—only billing practice requirements are affected.
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What to do
by Nov 30, 2026 · 6 steps
01Billing team must immediately review and update billing workflows to eliminate separate billing of Blood Product Administration services.
02Update billing software configurations and denial management rules to recognize that blood product administration is now bundled into facility encounter revenue codes for ER, Clinic, and Treatment/Observation Room settings.
03Instruct providers and clinical staff to document blood product administration as part of the facility encounter rather than as a separate billable service.
04Verify that claim scrubbing logic does not attempt to bill blood product administration separately after December 1, 2026, as these claims will be denied.
05Train billing staff to educate providers that this is a billing practice change only—there is no change to coverage or patient benefits.
06Monitor initial claims submissions after the effective date and address any denials related to bundled blood product administration services.
Original notice
[California] Blood Product Administration services will no longer be billed separately
providernews.anthem.com · Always check the source before changing claims.