Anthem’s 2026 Reimbursement Changes: What Providers Need to Know

Anthem’s reimbursement policy changes, effective April 1, 2026, will directly impact how providers are paid for preventive services, same-day sick visits, and screening-related care.

If your organization relies on preventive care visits as a consistent revenue stream, these updates aren’t just technical; they’re operational.

Here’s a clear breakdown of what’s changing and what you should be doing now.

Key Takeaway: Same-Day Visits Will Be Paid Differently

One of the most significant updates affects same-day preventive and sick visits under Medicare Advantage plans.

  • Preventive visit: 100% reimbursement
  • Sick visit (same day): 50% reimbursement

To receive reimbursement for the sick visit, Modifier 25 is required, and diagnosis codes must support both services. This also applies to preventive and wellness visit combinations.

Important exception: Federally Qualified Health Centers (FQHCs) and Rural Health Centers (RHCs) are excluded from this rule.

Preventive Visits Now Include More Services (Bundled Reimbursement)

For commercial plans, Anthem is expanding what is considered part of a preventive visit — meaning fewer services will be reimbursed separately.

Services now bundled into preventive care include:

  • Counseling services
  • Medical nutrition therapy
  • Screening services
  • Additional other Evaluation & Management (E/M) services
  • Annual gynecological exams
  • Prolonged services
  • Vision screenings

These services are not eligible for separate reimbursement when performed on the same day as a preventive visit.

Does Modifier 25 Still Work? Yes and No

Modifier 25 is often used to indicate a separate, significant E/M service, but its impact is changing.

Yes, it is still required to report a same-day sick visit. No, it will not override bundling rules for services included in preventive care.

Modifier 25 is still necessary, but no longer sufficient to guarantee payment.

What Providers Should Be Doing Now

With these changes now in effect, the focus shifts from preparation to active monitoring and adjustment.

1. Review Recent Claims Activity

Look at claims from April 1 forward:

  • Are same-day visits reimbursing as expected?
  • Are you seeing reductions or denials tied to these policies?

2. Identify Revenue Impact

Take a closer look at how these changes are affecting your bottom line. For example:

  • How often are preventive and sick visits happening on the same day?
  • Are services you previously billed separately now being bundled?
  • Are you receiving less reimbursement for common visit types?

Even a quick review can help you spot trends early.

3. Reinforce Documentation and Coding Practices

Ensure providers and coding teams are aligned on:

  • When Modifier 25 is required
  • When services are no longer separately reimbursable
  • Proper diagnosis coding to support distinct services

4. Adjust Scheduling and Workflow as Needed

If certain visit combinations consistently reduce reimbursement:

  • Reevaluate how appointments are structured
  • Consider whether separating services (when appropriate) makes sense operationally

5. Monitor Denials and Payer Feedback

Track denial trends closely:

  • Are they tied to bundling rules?
  • Are modifiers being rejected?

Use this data to refine processes quickly.

The Bigger Picture: A Shift Toward Bundled Care

These updates are part of a larger trend: payers are redefining what qualifies as a “separate” service.

For providers, that means less reliance on modifiers alone, greater emphasis on documentation, intent, and visit structure, and more coordination across teams.

Final Thoughts

Anthem’s 2026 reimbursement changes aren’t just about coding. They affect how care is scheduled, documented, and reimbursed.

Organizations that proactively adjust workflows and educate their teams will be better positioned to protect revenue, reduce denials, and stay compliant.

If you’re unsure how these updates will impact your practice, now is the time to evaluate your current processes and make adjustments before they take effect. If you have questions about how these updates apply to your organization, our team is here to help you evaluate your processes and identify potential revenue impacts.


What Buyers and Sellers Should Know About Quality of Earnings

Buying or selling a business is rarely just a financial event. It is a defining moment, one that carries opportunity, risk, and significant financial consequences.

The financial statements may show growth. EBITDA may appear strong. But when valuation, negotiations, and capital are on the line, surface-level numbers are not enough.

You need clarity. You need confidence. You need to know the earnings will hold up.

At Harding, Shymanski & Company (HSC), our Quality of Earnings (QoE) services are designed to provide that clarity so you can make critical decisions from a position of strength rather than uncertainty.

What Does a Quality of Earnings Report Really Deliver?

A Quality of Earnings report goes beyond reported results to evaluate the sustainability and reliability of earnings. It identifies what a business truly earns on an ongoing basis — and where potential risks may be hidden.

At HSC, our analyses focus on:

  • Determining whether revenue is recurring and sustainable
  • Evaluating and normalizing EBITDA
  • Assessing working capital requirements
  • Identifying risks such as non-GAAP practices, labor force stability, IT and infrastructure risks, regulatory compliance, etc.
  • Reviewing balance sheet exposures and debt structure
  • Addressing tax considerations when relevant

The objective is not simply to confirm numbers. It is to provide a clear, defensible understanding of earnings power so you can move forward without second-guessing your decisions.

Unverified Earnings = low confidence and high risk. Quality of Earnings Verified Earnings = high confidence and low risk

For Buyers: Protecting Your Investment

When acquiring a business, confidence in the numbers protects more than just price; it protects your capital, your strategy, and your credibility.

Our team evaluates the financial story behind the business to ensure reported performance reflects sustainable operations. We validate EBITDA, assess add-backs, analyze margin trends, and evaluate working capital needs with a transaction-focused lens.

This helps you:

  • Enter negotiations grounded in accurate valuation
  • Identify financial or operational risks before closing
  • Avoid overpaying based on temporary performance
  • Minimize surprises after the deal is complete

We understand how diligence findings affect negotiations and deal structure. Our role is to provide clear, objective insight so you can make informed decisions with confidence.

For Sellers: Protecting the Value You’ve Built

If you are preparing to sell, diligence will test both your numbers and your narrative.

A sell-side Quality of Earnings engagement with HSC allows you to prepare proactively. By identifying adjustments, normalizing earnings, and addressing potential concerns before buyers begin their review, you reduce uncertainty and strengthen credibility.

This preparation helps you:

  • Defend valuation with confidence
  • Reduce the risk of price reductions late in the process
  • Respond to diligence questions without scrambling
  • Maintain momentum and control during negotiations

Preparation reduces stress. It creates stability during a process that can otherwise feel unpredictable. Most importantly, it helps protect the value you’ve worked years to build.

What Sets HSC Apart

Transactions require more than technical accounting expertise. They require steady guidance, thoughtful communication, and a practical understanding of how financial findings impact real-world decisions.

At HSC, we combine:

  • Deep technical knowledge
  • Real transaction experience across industries
  • A business-minded perspective
  • Clear, direct communication throughout the process

We work closely with business owners, private equity groups, investment bankers, lenders, and legal counsel. Our team understands the pressure that accompanies a transaction, and we approach every engagement with professionalism, responsiveness, and discretion.

You will not receive a report in isolation. You will have a team that stays engaged, communicates early, and provides perspective as findings develop.

Our Structured Approach to Quality of Earnings

We follow a disciplined process designed to create clarity without unnecessary disruption:

  1. Define scope and objectives aligned with your transaction goals
  2. Gather and analyze detailed financial information
  3. Identify adjustments, trends, and potential risks
  4. Deliver a clear, well-supported report with actionable insight

Preliminary findings are communicated as they are identified, allowing you to address issues in real time. Most engagements move from initial data request to preliminary results within three to four weeks, depending on complexity.

Our focus is efficiency, transparency, and meaningful insight.

A Trusted Advisor in Critical Moments

A transaction represents a pivotal point in the life of a business. Decisions made during this period can have lasting financial impact.

At HSC, our Quality of Earnings services provide more than analysis. We provide clarity, credibility, and steady guidance when it matters most.

Whether you are evaluating an acquisition, preparing to sell, or bringing in outside investors, we help you move forward with confidence, knowing the numbers are understood, the risks are evaluated, and the path ahead is clear.

If you’re preparing for a transaction or evaluating your options, our team is here to help you understand the numbers and move forward with confidence. Schedule a confidential discussion with our transaction advisory team.


Harding, Shymanski & Company, P.S.C. is an accounting and advisory firm serving companies, nonprofits, and healthcare organizations from offices in Evansville, Indiana, and Louisville, Kentucky. For more than 50 years, we have helped clients across the United States navigate complex tax, accounting, and transaction decisions. Our Transaction Advisory Services team works with buyers and sellers throughout the deal process to identify risks, evaluate earnings quality, and support confident decisions.

Meals and Entertainment Quick Reference Guide

Understanding the tax treatment of business meals, entertainment, and related expenses continues to be a challenge for many business owners. Deductibility rules have shifted over time, temporary provisions have expired, and additional changes are scheduled to take effect beginning in 2026. As a result, expenses that were once fully deductible, or partially deductible, may now be limited or disallowed altogether.

The IRS rules governing business meal deductions, entertainment expenses, employee meals, and business gifts are highly specific and documentation-driven. Misclassifying these expenses can lead to missed deductions, compliance issues, or unwanted scrutiny during an audit. This is especially important for businesses that frequently incur client meals, employee travel expenses, or host employee events.

To help businesses navigate these rules with confidence, we’ve created a Meal and Entertainment Quick Reference Guide. This resource outlines the current deductibility rules and highlights upcoming changes so business owners and financial decision-makers can plan ahead and avoid surprises at tax time.

Have additional questions? Contact our tax experts to learn more.

Tax laws and guidance continue to evolve. To stay informed about changes that may affect your business, follow us on LinkedIn and Facebook or sign up to receive our newsletter, where we regularly share timely tax updates and insights.

Updated: Manufacturing in Foreign Trade Zones – Explore the Savings

Benefits of manufacturing in Foreign Trade Zones

Is your business paying significant duty and excise tax on foreign imports? If you import raw materials to manufacture and sell the product in the United States or re-export the finished product, you might be able to benefit from a foreign trade zone (FTZ).

What is a Foreign Trade Zone?

The U.S. government first created foreign trade zones to attract and promote international business in 1934.  Manufacturing activity in FTZs became broadly permitted starting in 1971.  Today, there are 260+ FTZ projects and nearly 400 subzones nationwide, serving as critical hubs for manufacturers, distributors, and e-commerce companies.

The term “foreign trade zone” (FTZ) means a discrete area located in or adjacent to a port of entry that is authorized by Congress to receive preferential treatment under the customs laws of the United States. FTZs are not considered to be in the customs territory of the United States. This allows a business to import and store foreign merchandise without paying customs duties or Federal excise tax until the merchandise enters U.S. commerce.

2025 update: With the elimination of the de-minimis exemption in recent trade policy changes (which had previously allowed duty-free imports under $800), FTZs have become even more valuable, especially for e-commerce and consumer goods companies facing higher tariff exposure.

What will an FTZ do for me?

There are several benefits for a business to utilize an FTZ. A manufacturer that imports raw material into the United States is required to pay duty at the time the raw material enters the country. However, merchandise or goods brought into an FTZ are not assessed duty until the merchandise leaves the zone or enters U.S. commerce.

In addition, if the imported merchandise is brought into an FTZ and then exported back out of the country and does not enter into U.S. commerce, no duty is ever due. There are also no time limitations on how long goods can remain in an FTZ, regardless of whether the goods are subject to duty.

Why this matters now: In today’s volatile tariff environment, in which a universal 10% tariff began in April, and county-specific ‘reciprocal tariffs’ fully took effect in recent trade policy changes, companies are relying on FTZs to defer duty costs and preserve cash flow until the moment goods actually enter the U.S. market.  Note that many of the reciprocal tariffs were paused, delayed, or modified as continued negotiations take place.

U.S. Import Duty Basics

U.S. duty or import duty is a tax on goods that arrive in the United States Customs port with the intent to unload the goods and enter them into U.S. commerce. There are several different types of import duties, which are calculated in a variety of ways. The import duty depends on the type of product imported, how much is being imported, its declared value, from which country the product was exported, and several other factors. The import duty can range from zero to 100% or more of the product’s declared value.

Tip: FTZs also provide “inverted tariff” benefits — where duty rates on finished products may be lower than on raw components. In those cases, companies can choose to apply the lower finished-goods rate, which can create significant savings.

Can I Manufacture or Assemble in an FTZ?

Generally, yes. Foreign and domestic merchandise brought into an FTZ can be manipulated or manufactured in the zone unless it is prohibited by law. The business can then store, sell, exhibit, separate, repack, assemble, distribute, sort, grade, clean, mix with foreign or domestic merchandise, or manipulate the merchandise within the FTZ.

Foreign production equipment, such as machinery or parts for specific equipment to manufacture merchandise, may be brought into an FTZ. No duty shall be assessed on imported production equipment until it is completely assembled, installed, tested, and used in the production for which it was intended.

A business that manufactures in an FTZ does not pay duty on waste, scrap, and yield loss. For example, a plastic facility manufacturing polysulfone (5% duty) imports and uses the raw material polypropylene (also 5% duty). During the production process, 10% of the raw material polypropylene is scrapped and considered obsolete. If this business operates outside an FTZ, it will pay $50,000 in duty on $1,000,000 of imported polypropylene. If the business utilizes the FTZ, no duty is owed on the polypropylene when it is brought into the zone. In addition, 10% or $100,000 of the polypropylene is lost during the production cycle. Assuming all of the end product is sold in the U.S., the 5% duty totals only $45,000. This is a savings of 10% in duty.

Modern twist: Increasingly, FTZ manufacturers are using automation, blockchain tracking, and real-time customs compliance software to streamline operations and reduce compliance risks. These tools make FTZ participation easier and more efficient than in years past.

Additional Benefits of FTZs

An additional benefit of an FTZ is protection against theft. After the merchandise has been manipulated or manufactured in an FTZ, the merchandise will be taken under the supervision of the Secretary of the Treasury. As long as the tariff classification has not changed since entry or during the manufacturing process, merchandise will be taken under supervision through electronic compliance systems, audits, and site inspections within the foreign trade zone. A declared value will be determined, and the duty or excise tax on the merchandise exempted while in the FTZ.

Bottom Line

There are several benefits to utilizing an FTZ. In 2025, FTZs are increasingly considered essential tools for tariff management and supply chain resilience. Whether you’re a manufacturer, distributor, or e-commerce retailer, the use of an FTZ can increase cash flow and profitability under the right circumstances.

Have questions about how an FTZ strategy could benefit your business?
Reach out to our manufacturing industry experts. As leaders of our Manufacturing Industry Team, Brant and John can help you evaluate opportunities, model potential savings, and navigate the application process.


This article provides general information and should not be considered specific tax or legal advice. Consult qualified professionals for your specific situation.

Find more information about FTZs from the International Trade Administration and U.S. Customs and Border Protection.

Beneficial Ownership Information (BOI) Reporting

Beginning on January 1, 2024, many companies in the United States are required to report information about their beneficial owners (i.e., the individuals who ultimately own or control the company). Companies must report the information to the Financial Crimes Enforcement Network (FinCEN), which is a bureau of the Treasury Department, through an electronic filing system. The beneficial ownership information (BOI) reporting requirements are part of the Corporate Transparency Act.

Reporting entitiesGenerally, any corporation, limited liability company, or any other entity that is created by filing a document with a secretary of state or similar office under state or tribal laws, or is formed under foreign law and registered to do business in the United States by filing a document with a secretary of state or similar office under state or tribal laws, is a reporting company that must disclose information regarding its beneficial owners and its company applicants to FinCEN under the Corporate Transparency Act.

However, there are exclusions for heavily regulated entities that already report such information to other federal agencies, or companies with real business activities that are not perceived to be a high risk for money laundering. Additionally, the reporting requirements do not apply to an inactive entity.

Beneficial ownerA beneficial owner is an individual who, directly or indirectly, through any contract, arrangement, understanding, relationship, or otherwise, either:

  • exercises substantial control over the reporting company; or
  • owns or controls at least 25% of the ownership interests of the reporting company.

However, beneficial owners do not include minor children; nominees, intermediaries, custodians, or agents; employees; inheritors; or creditors.

Company applicant. A company applicant is the individual who files the document with a secretary of state or any similar office under state or Indian tribe law that:

  • creates the domestic reporting company, or
  • registers the foreign reporting company to do business in the United States.

Further, the individual who is primarily responsible for directing or controlling that filing by another individual is also a company applicant.

Information to be reported. A reporting company must disclose the identity of each beneficial owner of the company and each company applicant. For each individual who is a beneficial owner or a company applicant, the reported information must include:

  1. full legal name;
  2. date of birth;
  3. residential street address; and
  4. an identifying number from an acceptable identification document such as a passport or U.S. driver’s license, and the name of the issuing state or jurisdiction of identification document.

The reporting company must also provide an image of the identification document used to obtain the identifying number in item four.

Filing deadlines for initial reports. Domestic reporting companies created or registered to do business in the United States and foreign reporting companies registered to do business in the United States before January 1, 2024, must file their initial report with FinCEN no later than January 1, 2025. Newly created or registered companies created or registered to do business in the United States in 2024 have 90 calendar days to file after receiving actual or public notice that their company’s creation or registration is effective.

If your company was created or registered on or after January 1, 2025, it must file its initial beneficial ownership information report within 30 calendar days after receiving actual or public notice that its creation or registration is effective. Additionally, penalties may be imposed for failure to file. If you have any questions on this proposed legislation, please contact your HSC service leader or call our office at 800-880-7800.

Certified Registered Nurse Anesthetist (CRNA) Billing

Join us as we explore the complexities of Certified Registered Nurse Anesthetist (CRNA) billing with insights from a seasoned expert – Karen Schnell, Director of Operations at HSC Medical Billing & Consulting. In this video, we explore key questions about CRNA practice, including:

✅Can a CRNA practice independently without an anesthesiologist?

✅What is Medical Direction, and how does it differ from Supervision?

✅How are short durations defined when an anesthesiologist is absent?

✅How do insurance companies determine the type of anesthesia service provided?

✅What are the billing implications for different case volumes?

About the Expert:

Karen Schnell is the Director of Operations at HSC Medical Billing & Consulting, LLC. She has over 30 years of experience working in healthcare coding and billing. Her experience includes performing medical chart audits, paper and electronic claims submission, managed care contracting, oversight of accounts receivable follow-up, check-in and check-out functions, manual and electronic payment posting, patient accounts follow-up, coding, and entry of various specialties. Prior to working with HSC Medical Billing & Consulting, LLC, she was the Director of Business Services at Welborn Clinic.

Karen became certified in the NextGen Practice Management System in 2004 where she played an integral part in the establishment of the NextGen Practice Management and Electronic Medical Records System for Welborn Clinic. She is a past member of the Welborn Clinic Compliance Committee, Managed Care Committee, HIPAA Committee, and Information Management Committee.

Karen obtained her certification in coding in 1999 through the American Academy of Professional Coders (AAPC) where she remains certified and a member still today. She is a member of the Indiana Part B Provider Outreach and Education Advisory Group (POE AG) with Wisconsin Physicians Service Medicare.

The National Debt: Key Points

The National Debt is a huge and complicated topic. In today’s video, HSC Senior Executive Consultant John Key breaks down what the National Debt is and touches on how we got here.

About the Expert:

John Key joined Harding, Shymanski & Company in 2023 as the Senior Executive Consultant in our Advisory Services Department after retiring from his position as Director of Strategic Initiatives at Stock Yards Bank & Trust Company. Before joining Stock Yards through a merger with Commonwealth Bank & Trust, John was President & CEO. He spent 40 years in the banking industry.

John received his Bachelor of Science degree from the University of Southern Indiana. He is a graduate of the School of Banking, University of Wisconsin, ABA Commercial Lending School; and the IBA Commercial Lending School and holds many other professional certifications. In addition to being involved with the “March for Babies,” John has been associated with the Boy Scouts of America, the American Heart Association, the United Way, the Memorial Cancer Center, and many other philanthropic organizations throughout his career. John is also a past Board member of the Indiana and Kentucky Bankers Associations.

Could outsourcing a CFO be right for your company?

Take your business to the next level.

About this time of year, we all focus on our taxes.

The challenge is that often waiting until the last minute is not the best business decision. 

What if you were to plan ahead of time to determine what you need to take your business to the next level? 

What if it’s time for a CFO? 

Watch this short video for a brief overview: https://resources.hsccpa.com/project/the-benefits-of-hiring-an-outsourced-cfo/

Yes, hiring a CFO may seem to be out-of-reach–however, have you considered an outsourced CFO? 

Watch the video for some keen insights. 

You may find that the timing for your business is perfect.

Lean Inventory Valuation: Lean Accounting and GAAP Compliance Introduction

(Published in October 31, 2017 issue of Thomson Reuters “Tax & Accounting”)
Lean Accounting refers to a collection of principles, practices and tools that are used by lean companies to measure the business, control operations, analyze and make sound financial decisions and finally improve all financial processes.  Lean Accounting practices have been around since the early 1990’s, and as long as they’ve been around there have been some that argue Lean Accounting practices don’t comply with Generally Accepted Accounting Principles (GAAP). This idea then usually leads to a debate about Lean Accounting vs. conventional inventory valuation systems. Continue reading “Lean Inventory Valuation: Lean Accounting and GAAP Compliance Introduction”

Successful Succession Planning Strategies

(Published in Construction Accounting and Taxation, May/June 2017 issue)
As 70 million baby boomers reach retirement age, it is estimated that 12 million privately owned businesses will sell or bequeath assets worth $10 trillion over the next two decades.1 Proper succession planning is just as crucial for the boomers’ employees as it is for the exiting business owners. Our firm has seen a steadily growing number of contractor clients enter into business transactions over the past two years, and there are many more working on plans for that day. Continue reading “Successful Succession Planning Strategies”