All PlansBilling CodesMedium impact
[Ohio] Outpatient facility claims update: modifier 26 (professional services) on UB‑04
Anthem BCBS·OH·Provider Bulletin
We identified it
May 3, 2026
Summary
Ohio outpatient facilities must now use modifier 26 (professional services) on UB-04 claim forms for specific billing scenarios. This affects how professional services are distinguished from technical components on facility claims.
Action Required
Immediately: Billing team must update UB-04 claim submission processes to include modifier 26 for professional services at outpatient facilities in Ohio. Review current claims to identify services requiring professional component billing and update billing software rules accordingly.