New policy for the reimbursement of administrative services for drugs, substances, and/or biologic agents

November 16, 2020

Effective January 18, 2021, Independence will require providers to submit administration procedure codes with appropriate drug, substance, and/or biologic agent codes. Our policies indicate that Independence will only cover the administration of drugs, substances, and/or biologic agents for an individual if the outlined criteria is met. Claims submitted without an appropriate drug, substance, and/or biologic agent code may not be covered.

New policies

For more information and the billing requirements, please refer to the following Independence policies, which were posted as Notifications on October 19, 2020, and will go into effect January 18, 2021:

  • Commercial: #00.10.43: Reimbursement for the Administration of Drugs, Substances, and/or Biologic Agents
  • Medicare Advantage: #MA00.051: Reimbursement for the Administration of Drugs, Substances, and/or Biologic Agents

To view the Notifications for these policies, visit our Medical and Claim Payment Policy Portal and select either Commercial or Medicare Advantage under Active Notifications.