Capital Equipment Reimbursement
Defines Anthem Blue Cross and Blue Shield's reimbursement stance on capital equipment used in inpatient and outpatient settings; affects providers billing for facility services under Anthem plans.
No material clinical or coverage changes in this revision.
Coverage Criteria
Capital equipment reimbursement criteria
Anthem does not reimburse separately for capital equipment used in facility services. Capital equipment is considered included in inpatient and outpatient reimbursement when it has a useful life of more than one year or is usable for more than one patient.
Definition of capital equipment
- Any single asset which has a useful life of more than one year, whether purchased outright, acquired through a capital lease or through donation.
- Inpatient and outpatient reimbursement includes all appropriate capital equipment or anything that can be used for more than one patient or could be determined to be a non-disposable supply or piece of equipment.
Examples (non-exhaustive)
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