CommercialReimbursementHigh impact
[New York] Reimbursement policy update: Bundled Services and Supplies — Facility
Anthem BCBS·NY · Critical Care, Emergency Medicine, General Surgery +3 more·Claims & Billing
Effective date
Apr 1, 2026
We identified it
May 3, 2026
Summary
Effective April 1, 2026, Anthem Blue Cross will no longer reimburse separately for blood product splitting, pooling, and thawing services, as well as professional/technical components and supplies for blood product administration and routine ECG when billed with facility or room fees. Facilities must bundle these services into primary service or facility fee reimbursement. Several new codes have been added to the related coding section for reference.
Action Required
By March 31, 2026: Billing team must update billing system edits and claim scrubbing rules to prevent submission of separate charges for blood product splitting, pooling, thawing (CPT 76014, 76019) and professional/technical components for blood product administration (CPT 96521, 96522, 96523) and routine ECG (CPT 99190, 99192) when billed on the same date of service as facility fees or procedure codes. Update charge capture templates in EMR/billing software to bundle these services into facility fees for Anthem commercial plans in New York. Train billing staff and providers on the new bundling requirements. Audit accounts with dates of service on or after April 1, 2026 for compliance. Failure to implement will result in claim denials and revenue loss. Reference the full policy at https://anthem.com/provider (New York) for complete details.