CommercialReimbursementHigh impact
[Georgia] Reimbursement policy update: Bundled Services and Supplies — Facility
Anthem BCBS·GA · Critical Care, Emergency Medicine, Hematology +2 more·Claims & Billing
Effective date
Apr 1, 2026
We identified it
May 3, 2026
Summary
Effective April 1, 2026, Anthem Blue Cross Blue Shield (Georgia) is bundling blood product splitting, pooling, and thawing services into facility fees with no separate reimbursement allowed. Additionally, professional/technical components and supplies for blood product administration and routine ECG will not be separately reimbursable when billed with room/facility fees or procedures. Specific HCPCS codes have been added to the related coding section.
Action Required
By March 15, 2026: Billing team must update billing system logic to bundle blood product services (splitting, pooling, thawing) into facility fees and deny separate reimbursement for these services when billed by facility providers. Update system edits to prevent separate billing of professional/technical components and supplies for CPT 96521, 96522, 96523, 99190, 99192, and routine ECG codes when submitted on the same date of service as facility or room fees. Review all encounter templates and billing worksheets to remove options for separate billing of these bundled services. Communicate changes to all clinical and billing staff. Failure to implement these changes will result in claim denials and revenue loss beginning April 1, 2026.