Payment Policy Updates July 2020

Here are the latest updates to our payment policies. You’ll need to log in to see the policy updates.

July 16, 2020

1. Elective Abortions – Facility Services
   Added revised purpose statement
   Revised the second paragraph and moved the references to “Field Locators” to the sub-bullets
2. Elective Abortions – Professional Services
   Added revised purpose statement
3. Group Psychotherapy Services (90853)
   Added revised purpose statement
4. Modifier 23 – Unusual Anesthesia
   Added revised purpose statement
5. Modifier 24 – Unrelated E&M Service in Post-Operative Period
   Added revised purpose statement
6. Modifier 47 – Anesthesia by Surgeon
   Added revised purpose statement
7. Modifier 50 – Bilateral Procedure
   Added revised purpose statement
   Added a link to the CMS National Physician Fee Schedule referenced in the policy
   Added second bullet in the exceptions section to indicate the policy does NOT apply to Ambulatory Surgery Centers (ASCs) that are reimbursed under ASC-APCs which have a different payment method for modifier 50
8. Modifier 62 – Two Surgeons
   Added the revised purpose statement
   Added a link to the CMS National Physician Fee Schedule referenced in the policy
9. Modifier GA – Waiver of Liability Issued as Required by Payer Policy
   Added revised PURPOSE statement
10. NDC Billing Guidelines – OP Facility Claims
    Annual review; no changes
11. NDC Billing Guidelines – Professional Claims
    Annual review; no changes
12. Urgent Care Center Services
    Added revised purpose statement

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