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[Georgia] Reimbursement policy update: Facility Guidelines for Claims Related to Professional Services — Facility
Act
by Nov 30, 2026
Effective date
Dec 1, 2026
Identified
Sep 2, 2026
Summary
Effective December 1, 2026, Anthem will no longer reimburse medical nutritional therapy (CPT 97802–97804; HCPCS G0270–G0271) and obesity counseling services (HCPCS G0421, G0447) when billed on UB-04 (facility claims). These services are now eligible for reimbursement ONLY when submitted on CMS-1500 (professional claim form) by the rendering provider. Billing teams must immediately audit billing workflows to prevent claim denials and ensure correct claim form submission.
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What to do
by Nov 30, 2026 · 8 steps
01Billing team must implement the following.
02Update billing software rules to block or flag submission of CPT codes 97802, 97803, 97804 and HCPCS codes G0270, G0271, G0421, G0447 on UB-04 claim forms.
03Configure system to route these services exclusively to CMS-1500 professional claim submission.
04Audit current workflows and encounter forms to identify any standing orders or templates that route these codes to UB-04.
05Communicate change to all providers and facility staff who order or document nutritional therapy and obesity counseling services.
06Train billing staff on new submission requirements.
07Failure to comply will result in claim denials for all affected codes submitted on UB-04 forms.
08Additionally, ensure participating providers understand the balance billing prohibition—they cannot bill members for denied claims due to this policy change.
Codes mentioned
978029780397804G0270G0271G0421G0447
Original notice
[Georgia] Reimbursement policy update: Facility Guidelines for Claims Related to Professional Services — Facility
providernews.anthem.com · Always check the source before changing claims.
Related changes
See all Anthem BCBS changes →[New York] Reimbursement policy update: Facility Guidelines for Claims Related to Professional Services — FacilityHighEffective Dec 1, 2026 · Claims & Billing[Ohio] Reimbursement policy update: Facility Guidelines for Claims Related to Professional Services — FacilityHighEffective Dec 1, 2026 · Claims & Billing[Virginia] Payment discontinued for select procedure codes effectiveHighEffective Jan 1, 2027 · Claims & Billing[Georgia] Reimbursement policy update: Facility Guidelines for Claims Related to Professional Services — FacilityHighEffective Oct 1, 2026 · Claims & BillingBrowse every Anthem BCBS change in the policy list
Related policy hubs
Anthem BCBS policiesGA policy changesCT policy changesIN policy changesKY policy changesMO policy changesNV policy changesNH policy changesNY policy changesOH policy changesWI policy changesEndocrinologyFamily MedicineGeneral PracticeInternal MedicineBariatric SurgeryCode 97802Code 97803Code 97804Code G0270Code G0271Code G0421Code G0447