Anthem announced in their March newsletters for Kentucky and Indiana markets that they will begin automatic pre-payment reviews of outpatient claims submitted with modifiers 24, 25, 58, 59, 78, 79, E1–E4, F1–F9, TA, LT, RT, LC, LD, RC, LM, RI, XE, XP, XS, and XU starting April 1, 2025.
We are in the process of reviewing this development and discussing potential strategies to support physicians in navigating this new policy and we would greatly appreciate your insights and comments on how this policy will affect your patients.
Due to the short timeframe before this policy goes into effect, we would appreciate your comments as soon as possible, but no later than Friday, April 4. Please send your comments to stephanie.woods@glms.org.
In addition to GLMS and KMA addressing this issue directly with Anthem, you may also utilize the Kentucky Department of Insurance’s Online Consumer Complaint form at https://insurance.ky.gov/ppc/forms/oc_info.aspx.