Aligning "assistant at surgery" reimbursement rates with industry standard in March

Update 1/24/24: Added the percent reimbursement change for the AS modifier for Medicaid.


Providing our members, your patients, the right care at the right cost is one of our top priorities as a nonprofit health plan. As we strive to meet this goal, we occasionally identify opportunities to better align our payment strategies with industry standards.

In March, we’ll align our “assistant at surgery” percent reimbursement rate with the Centers of Medicare and Medicaid Services (CMS) standard as follows:

Commercial & Medicare:

Modifier
% of fee schedule
Current Updated
80, 81, 82 20% 16%
AS (midlevel) 20% 13.6%

Medicaid:

The percent reimbursement for the AS (midlevel) modifier will change from 16% to 13.6%.