CommercialCoverageHigh impact
[Georgia] Expanding Site of Care Program for musculoskeletal and surgical procedures
Anthem BCBS·GA · Orthopedics, General Surgery, Neurosurgery +7 more·Provider Bulletin
We identified it
May 3, 2026
Summary
Anthem is expanding their Site of Care Program to include additional musculoskeletal and surgical procedures, which will require these services to be performed in lower-cost settings rather than hospital outpatient departments to receive full reimbursement.
Action Required
Immediately: Review the full policy bulletin at the provided URL to identify specific procedures affected. Update prior authorization workflows to verify site of care requirements before scheduling musculoskeletal and surgical procedures. Educate providers about potential reimbursement reductions for procedures performed in non-approved settings.