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[Georgia] New reimbursement policy: Inpatient Hospital Inclusive Services — Facility
Effective date
Feb 1, 2027
Identified
Nov 3, 2026
Summary
Effective February 1, 2027, Anthem Blue Cross and Blue Shield in Georgia will no longer separately reimburse specific inpatient hospital services (including blood products, DME, nursing, pharmacy, therapy, radiology guidance, and professional services like catheter insertion and chemotherapy administration) when billed on the same date of service as an inpatient admission. Services must be reported correctly on CMS-1500/837P (professional) or UB-04 (facility) forms to avoid denial; balance billing members is prohibited.
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What to do
Action · 6 steps
01Before February 1, 2027.
02Billing team: Review the policy details at Anthem's Georgia reimbursement policy page and identify all inpatient claims currently billing separately for blood products, DME, nursing, pharmacy, therapy services, radiology guidance, ECG, infusion/chemotherapy administration, and catheter insertion.
03Update charge entry and claim edits to ensure these services are not billed separately when reported on the same date of service as inpatient room and board charges; claims without this correction will be denied.
04Confirm professional services (blood product administration, chemotherapy administration, infusion drug administration, bladder catheter insertion, routine ECG) are reported on CMS-1500/837P forms when performed by clinicians—if submitted on UB-04 on the same date, they will not be reimbursed separately.
05Tell providers and front desk staff that treatment room and clinic services can no longer be billed separately on the same date as an inpatient semi-private room charge.
06Document that the practice will not balance bill members for these included services per Anthem's prohibition.
Original notice
[Georgia] New reimbursement policy: Inpatient Hospital Inclusive Services — Facility
providernews.anthem.com · Always check the source before changing claims.
Related changes
See all Anthem BCBS changes →[New York] New reimbursement policy: Inpatient Hospital Inclusive Services — FacilityHighEffective Feb 1, 2027 · Claims & Billing[Ohio] New reimbursement policy: Inpatient Hospital Inclusive Services — FacilityHighEffective Feb 1, 2027 · Claims & BillingBrowse every Anthem BCBS change in the policy list