Anthem BCBSHigh ImpactCoverage
[Georgia] Expanding Site of Care Program for musculoskeletal and surgical procedures
Published May 3, 2026
AI 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.
Plan Types
Commercial
States
GA
Specialties
ortho, general-surgery, neurosurgery, plastic-surgery, vascular-surgery, ent, urology, ob-gyn, sports-medicine, pm-r