One of my MAPD members recently contacted me. He had an office visit with a Pain Specialist. The doctor, or his nurse I believe, gave him a shot to help ease the pain. Not sure if these are always Epidural shots or not but I know a lot of seniors on Medicare plans see their pain specialist for this type of "shot" every month. This member was billed $295 for the shot as it was coded as an Outpatient procedure by the doctor's office. I called his MAPD plan, Anthem, and I was told that the if there was a concern about the bill being coded properly, he had to work with the providers billing service and not Anthem. I informed the member of what I was told so he called the providers office back and he was told that the proper billing codes were used for the procedure. It doesn't make sense to me that getting a shot like this in the doctor's office and not at a ambulatory surgical center or a hospital would be consider a "procedure" Can anyone enlighten me if the shot was billed properly? I have "googled" this several times, but I cannot seem to find a clear answer to this question.