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[Ohio] 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 outpatient 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 by the rendering provider on CMS-1500 (professional claim form). Billing teams must route these services to the correct claim form type to avoid denials.
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What to do
by Nov 30, 2026 · 5 steps
01Billing team must implement system changes to prevent these codes (97802, 97803, 97804, G0270, G0271, G0421, G0447) from being submitted on UB-04 facility claims for Anthem Commercial plans in affected states.
02Route all medical nutritional therapy and obesity counseling services to CMS-1500 professional claim forms only.
03Update billing software edits and encounter forms to enforce this requirement.
04Train providers and billing staff on the new routing rule.
05Document this change in internal billing procedures.
If missed: Failure to submit on correct claim form will result in claim denials and member balance billing is prohibited.
Codes mentioned
978029780397804G0270G0271G0421G0447
Original notice
[Ohio] 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[Georgia] 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 & BillingBrowse every Anthem BCBS change in the policy list
Related policy hubs
Anthem BCBS policiesOH policy changesCT policy changesGA policy changesIN policy changesKY policy changesMO policy changesNV policy changesNH policy changesNY policy changesWI policy changesEndocrinologyBariatric SurgeryInternal MedicineFamily MedicineGeneral PracticeCode 97802Code 97803Code 97804Code G0270Code G0271Code G0421Code G0447