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Commercial Reimbursement Policy Updates for November 1, 2024
Reimbursement PolicyRevision
Add-on Codes

Clarification to the definition of same group practice. No change to policy intent.

Anesthesia Services Professional and Facility

Clarification to the definition of same group practice. No change to policy intent.

Bundling Guidelines

Clarification to the definition of same group practice. No change to policy intent.

Drugs and Biologicals


Modifier JZ requirement language added to the policy. Clarification to the definition of same group practice. 

Evaluation and Management Services

Facility charges reimbursement guidelines added; separate reimbursement is not allowed.

Global Surgery

Clarification to the definition of same group practice. No change to policy intent.

Guidelines for Global Maternity Reimbursement

Clarification to the definition of same group practice. No change to policy intent.

Multiple and Bilateral Surgery

Clarification to the definition of same group practice. No change to policy intent.

Multiple Endoscopy Services

Clarification to the definition of same group practice. No change to policy intent.

NCCI Editing

Clarification to the definition of same group practice. No change to policy intent.

Opioid Treatment Program Reimbursement

Clarification to the definition of same group practice. No change to policy intent.

Pricing and Adjudication Principles

Clarification to the definition of same group practice. No change to policy intent.

Radiation Therapy Services

Clarification to the definition of same group practice. No change to policy intent.

Split Surgical Package

Clarification to the definition of same group practice. No change to policy intent.

Status Codes

Clarification to the definition of same group practice. No change to policy intent.

Telehealth

Clarification to the definition of same group practice. No change to policy intent.