CommercialReimbursementMedium impact
[Ohio] Reimbursement policy update: Bundled Services and Supplies — Facility
Anthem BCBS·OH · Critical Care, Hematology·Claims & Billing
Effective date
Apr 1, 2026
We identified it
May 3, 2026
Summary
Effective April 1, 2026, Anthem is bundling blood product services (splitting, pooling, thawing, and administration) into facility fees for inpatient settings in Ohio. Facilities can no longer bill these services separately on the same date of service as a room/facility fee or procedure. Six new HCPCS codes have been added to the related coding section.
Action Required
By March 15, 2026: Billing team must update billing system edits to prevent separate reimbursement claims for blood product splitting, pooling, thawing, and administration (codes 76014-76019, C1734, C1762, C1763, C1781, C1889, L8699) when billed on the same date of service as facility/room fees or procedures by facility providers. Review current claims processing workflows and update encounter templates to bundle these services into facility charges. Notify providers and facility billing staff of the bundling requirement. Failure to comply will result in claim denials for separately billed blood product services.