Anthem Blue Cross Blue Shield of California policy
Facility Guidelines for Claims Related to Professional Services – Facility
Facility Guidelines for Claims Related to Professional Services – Facility is a public Anthem Blue Cross Blue Shield of California policy (policy C-15004, effective Apr 1, 2026). It lists 10 CPT or HCPCS codes, 0 of them on the Anthem Blue Cross Blue Shield of California prior authorization list. Not a coverage decision; the payer's own document governs.
View the original policy (PDF) ↗
Check eligibility for free
No account required. Sign a BAA to see plan details, coordination of benefits and more
- Policy number
- C-15004
- Effective
- Apr 1, 2026
- Line of business
- Commercial
- States
- CA
- Source
- www.anthem.com
Codes in this policy
The CPT and HCPCS codes the policy names. A policy can name a code it excludes. Prior authorization status is from the Anthem Blue Cross Blue Shield of California prior authorization list.
| Code | Prior authorization | Description on the prior authorization list | Other Anthem Blue Cross Blue Shield of California policies |
|---|---|---|---|
| 99202 | Not listed | Policies naming 99202 | |
| 99281 | Not listed | Policies naming 99281 | |
| 99285 | Not listed | Policies naming 99285 | |
| 99401 | Not listed | Policies naming 99401 | |
| 99404 | Not listed | Policies naming 99404 | |
| 99411 | Not listed | Policies naming 99411 | |
| 99412 | Not listed | Policies naming 99412 | |
| 99499 | Not listed | Policies naming 99499 | |
| G0380 | Not listed | Policies naming G0380 | |
| G0384 | Not listed | Policies naming G0384 |
All Anthem Blue Cross Blue Shield of California policies · Anthem Blue Cross Blue Shield of California prior authorization CPT list