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[Ohio] 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 stop separately reimbursing moderate sedation services (revenue codes 0371 and 0372) when billed on inpatient facility claims with room and board charges in Ohio. The payer considers these services bundled into room and board payment, consistent with CMS policy. Practices must stop billing these codes separately on inpatient UB-04 claims or face denial.
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What to do
Action · 6 steps
01Before February 1, 2027: Billing team must review charge entry and claim edit logic to prevent revenue codes 0371 and 0372 from being submitted on inpatient facility claims (UB-04) alongside room and board charges for Anthem Commercial Ohio members.
02Tell providers and inpatient facility staff that moderate sedation will no longer be separately billed on inpatient claims; it is now bundled into facility payment.
03Update internal billing workflows and training so that these codes are not included on inpatient facility submissions.
04Watch for Anthem's next communication to confirm which inpatient settings and claim types are affected.
05After February 1, 2027, any claims submitted with these codes on inpatient UB-04 claims will be denied.
06If the practice submits such claims, monitor for denials and appeal with documentation that the claim was submitted in error.
Original notice
[Ohio] 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[Georgia] Reimbursement policy update: Moderate (Conscious) Sedation — Professional and FacilityMediumEffective Feb 1, 2027 · Claims & BillingBrowse every Anthem BCBS change in the policy list