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Anthem Blue Cross Blue Shield of California policies, page 9

Search Anthem Blue Cross Blue Shield of California's public medical, payment and drug policies by CPT or HCPCS code, keyword or policy number, with links to the payer's own documents. Links open the payer's own document; check its current version before relying on it.

576 public policies Substrate tracks for Anthem Blue Cross Blue Shield of California, by title.

Anthem Blue Cross Blue Shield of California policies
PolicyDetailsCodesSource
Medicare Advantage 2018 Precertification RequirementsEffective Jan 1, 2018 · CA, CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, VA, WI158Original policy ↗
Medicare Advantage Precertification Requirements – 2019CA, CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, VA, WI191Original policy ↗
Medicare Advantage Provider GuidebookEffective Dec 1, 2018 · Medicaid · CA—Original policy ↗
Medicare Advantage Provider ManualEffective Oct 1, 2021 · Medicaid · CA—Original policy ↗
Medicare Advantage Provider ManualEffective Oct 1, 2020 · CA—Original policy ↗
Medicare Advantage Provider ManualEffective Oct 1, 2022 · Medicaid · CA—Original policy ↗
Medicare Advantage Provider ManualEffective Jul 1, 2020 · CA—Original policy ↗
Medicare Advantage Provider ManualEffective Dec 1, 2020 · Medicaid · CA—Original policy ↗
Medicare Advantage Provider ManualEffective Apr 8, 2022 · CA—Original policy ↗
Medicare Advantage Provider ManualMULTI-BC-CR-PM-008699-26-GRP2620 · Effective Apr 1, 2026 · Medicaid · CA—Original policy ↗
Medicare Advantage Provider ManualEffective Jan 1, 2020 · CA—Original policy ↗
Medicare Advantage Provider ManualMULTI-BC-CR-PM-037957-23-CPN37889 · Effective Dec 1, 2023 · Medicaid · CA—Original policy ↗
Moderate (Conscious) Sedation – Professional and FacilityC-25001 · Effective Jul 1, 2026 · Commercial · CA7Original policy ↗
Modifier 22 – ProfessionalC-12003 · Effective Jan 1, 2026 · Commercial · CA—Original policy ↗
Modifier 25 and 57: Evaluation and Management with Global ProceduresC-09011 · Effective Jan 1, 2026 · Commercial · CA8Original policy ↗
Modifier 26 and TC: Professional and Technical ComponentC-20004 · Effective Jan 1, 2026 · Commercial · CA—Original policy ↗
Modifier 50 and 51: Multiple and Bilateral Surgery – ProfessionalC-08004 · Effective Jul 1, 2026 · Commercial · CA61Original policy ↗
Modifier 62 - ProfessionalC-21005 · Effective Apr 1, 2026 · Commercial · CA—Original policy ↗
Modifier 66 - ProfessionalC-21006 · Effective Jan 1, 2027 · Commercial · CA—Original policy ↗
Modifier 66: Surgical Teams – ProfessionalC-21006 · Effective Jul 1, 2024 · Commercial · CA—Original policy ↗
Modifier FB – Professional and FacilityC-22003 · Effective Jul 1, 2024 · Commercial · CA—Original policy ↗
Modifier Rules - ProfessionalC-08010 · Effective Jul 1, 2024 · Commercial · CA11Original policy ↗
Modifier Usage - FacilityC-23005 · Effective Jul 1, 2026 · Commercial · CA—Original policy ↗
Modifier Usage - ProfessionalC-08010 · Effective Jan 1, 2027 · Commercial · CA11Original policy ↗
Modifiers 59 and XE, XP, XS, and XU: Distinct Procedural Service - ProfessionalC-09006 · Effective Jul 1, 2026 · Commercial · CA130Original policy ↗
Modifiers 80, 81, 82 and AS: Assistant at Surgery - ProfessionalC-08006 · Effective Apr 1, 2026 · Commercial · CA44Original policy ↗
Modifiers 90, 91, and 92: Laboratory Services – Professional and FacilityC-26002 · Effective Jan 1, 2027 · Commercial · CA6Original policy ↗
Molecular Signature Test for Predicting Response to Tumor Necrosis Factor Inhibitor TherapyLAB.00042 · Commercial1Original policy ↗
MRI Guided High Intensity Focused Ultrasound Ablation for Non-Oncologic IndicationsMED.00057 · Commercial6Original policy ↗
Multiple Diagnostic Imaging Procedures – Professional and FacilityC-25003 · Effective Jul 1, 2026 · Commercial · CA—Original policy ↗
Multiple Procedure Payment Reduction – ProfessionalC-23003 · Effective Oct 1, 2026 · Commercial · CA—Original policy ↗
Multiple Surgery - FacilityC-21004 · Effective Jan 1, 2026 · Commercial · CA—Original policy ↗
Multiple Surgery - FacilityC-21004 · Effective Jan 1, 2026 · Commercial · CA—Original policy ↗
Multiple Surgery - FacilityC-21004 · Effective Jan 1, 2027 · Commercial · CA—Original policy ↗
Multiplex Autoantigen Microarray Testing for Systemic Lupus ErythematosusLAB.00036 · Commercial2Original policy ↗
Near-Infrared Coronary Imaging and Near-Infrared Intravascular Ultrasound Coronary ImagingRAD.00057 · Commercial1Original policy ↗
Network Participation Request – Behavioral Health FacilityCommercial · CA—Original policy ↗
Non-invasive Cardiac Management and Monitoring SystemsMED.00134 · Commercial5Original policy ↗
Non-Patient Laboratory Services – FacilityC-21001 · Effective Jan 1, 2026 · Commercial · CA—Original policy ↗
Nurse Practitioner and Physician Assistant Services - ProfessionalC-20001 · Effective Jan 1, 2026 · Commercial · CA—Original policy ↗
Observation Services - FacilityC-11005 · Effective Oct 1, 2026 · Commercial · CA14Original policy ↗
Observation Services- FacilityC-11005 · Effective Jul 20, 2022 · Commercial · CA—Original policy ↗
Once-per-Lifetime Procedures - ProfessionalC-15003 · Effective Jul 1, 2026 · Commercial · CA—Original policy ↗
Opiod Use Assessment BrochureCommercial · CA, CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, VA, WI—Original policy ↗
Oral, Pharyngeal and Maxillofacial Surgical Treatment for Obstructive Sleep Apnea or SnoringSURG.00129 · Commercial23Original policy ↗
Out of Network Outpatient Treatment RequestCABC-CD-002132-22 · Medicaid · CA—Original policy ↗
Outpatient Drug Screen Testing - FacilityC-17004 · Effective Jan 1, 2026 · Commercial · CA5Original policy ↗
Outpatient Facility Revenue Code Billing Requirements - FacilityC-18003 · Effective Jul 1, 2024 · Commercial · CA—Original policy ↗
Outpatient Facility Revenue Code Billing Requirements - FacilityC-18003 · Effective Oct 1, 2026 · Commercial · CA—Original policy ↗
Overhead Expense for Office Based Surgery and Diagnostic Testing- ProfessionalC-13002 · Effective Jan 1, 2026 · Commercial · CA2Original policy ↗

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Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.

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