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CommercialReimbursementHigh impact

[California] Reimbursement policy update: Preventive Medicine and Sick Visits on the Same Day

Anthem BCBS·CA · Family Medicine, Internal Medicine, General Practice +1 more·Claims & Billing
Effective date
Not stated
We identified it
May 3, 2026
Days to comply

Summary

Anthem California has updated their reimbursement policy regarding billing for preventive medicine visits and sick visits performed on the same day. This policy change affects how providers can bill and get reimbursed when addressing both preventive care and acute illness during a single patient encounter.

Action Required

Action needed
Immediately: Review the full policy details at the provided URL to understand specific billing requirements for same-day preventive and sick visits. Update billing procedures and train staff on proper coding when both services are provided during one encounter. Verify reimbursement rules in billing system to ensure compliance with new policy.