Insurance Updates
Anthem
Anthem Update – Modifier Rules and Guidelines for “Always Therapy” Codes
Recently, Anthem announced they were changing their modifier rules for physical medicine and rehabilitation codes. This change took effect November 1, 2021. These codes and modifiers align with the codes the Centers for Medicare & Medicaid Services (CMS) has...
Anthem 10-7
Anthem has been denying codes 98940/98941 as not covered by this provider type. We have reached out to Anthem executives about this issue and sent several examples to them. Anthem has informed us that they have identified the system issue that was causing these...
Humana
Prior Authorization
Humana has reinstated the prior authorization requirement on the first date of service. This went into effect starting October 1, 2019. Please remember to obtain authorization at the start of care and not after the eighth...
Modifiers
Providers have been experiencing several issues regarding claims processing with Humana Commercial insurance plans. Most of these are due to modifiers not being attached. They have recently stated they follow Medicare guidelines and therefore you...
WellCare
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Passport
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Humana Medicaid
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Aetna Better Health
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Medicare
Table Talk: New ABN Released | Transition Required by May 12, 2026
Question I thought the new ABN was released? Can you confirm? Answer Yes! As of March 13, 2026 - the new ABN is now released. We've made it easy for KAC members to download the new ABN. Medicare has released an updated version of the Advance Beneficiary Notice of...
Medicare ABN Form Set to Expire January 31, 2026
The Advance Beneficiary Notice of Noncoverage (ABN), which must be provided to patients when Medicare may not cover a service, is currently scheduled to expire on January 31, 2026. Chiropractic physicians should be aware that the Centers for Medicare and Medicaid...
Miscellaneous
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