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[Georgia] Reimbursement policy update: Moderate (Conscious) Sedation — Professional and Facility
Effective date
Feb 1, 2027
Identified
Nov 3, 2026
Summary
Effective February 1, 2027, Anthem will no longer separately reimburse moderate sedation services (revenue codes 0371 and 0372) on inpatient facility claims when reported with room and board charges; reimbursement is now bundled into room and board payment. Billing teams must stop billing these codes separately on inpatient UB-04 claims for Anthem Commercial members in Georgia and other affected states.
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What to do
Action · 6 steps
01Before February 1, 2027.
02Billing team: Update charge entry and claim edits so that revenue codes 0371 and 0372 are no longer billed separately on inpatient facility claims (UB-04) for Anthem Commercial members; confirm these codes are removed or suppressed for inpatient stays with room and board charges.
03Billing team: Review current inpatient claims to identify any pending or recently submitted claims that include these revenue codes and determine whether resubmission is needed after the effective date.
04Tell providers and front desk staff that moderate sedation will no longer be billed as a separate line item on inpatient facility claims, as it is now included in room and board reimbursement.
05Inform providers that balance billing members for this service is prohibited under the policy.
06Claims without this adjustment will be denied by Anthem.
Original notice
[Georgia] Reimbursement policy update: Moderate (Conscious) Sedation — Professional and Facility
providernews.anthem.com · Always check the source before changing claims.
Related changes
See all Anthem BCBS changes →[New York] Reimbursement policy update: Moderate (Conscious) Sedation — Professional and FacilityMediumEffective Feb 1, 2027 · Claims & Billing[Ohio] Reimbursement policy update: Moderate (Conscious) Sedation — Professional and FacilityHighEffective Feb 1, 2027 · Claims & BillingBrowse every Anthem BCBS change in the policy list