Anthem – Reimbursement Policy Update: Laboratory and Venipuncture (Professional)

Beginning with dates of service on or after January 1, 2021, Anthem Blue Cross and Blue Shield (Anthem) will update the policy language to indicate Modifier 90 will not allow reimbursement when reported in a Place of Service Office (11).

Modifier 90 is defined as Reference (Outside) Laboratory: When laboratory procedures are performed by a party other than the treating or reporting physician or other qualified health care professional, the procedure may be identified by adding modifier 90 to the usual procedure number.

Source: https://anthempc-attachments-prod.s3.us-west-2.amazonaws.com/pdf/articles/Reimbursement policy update: L... - mo5745.pdf