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Updated payment policies now available

April 2, 2026

This article is for all providers caring for our members

The following payment policies, updated in Q1 2026, are now available on Provider Central.

Payment policy	Updates
Allergy Services	New template; annual review
Chiropractic	New template; annual review
CPT and HCPCS Modifiers	Added RA modifier
Diabetic Care	Annual review; formatting updates Removed prior authorization requirements for codes A4238-A4239, A9277, E2103 Updated Medicare Advantage requirements for codes A4238-A4239
Durable Medical Equipment	Annual review; formatting updates
Evaluation and Management	Revised descriptor for code G2211
Home Infusion	Annual review; updated template Edited to clarify that Blue Cross does not reimburse IV RN or a per diem if the medication administered was billed/paid under the member’s pharmacy benefit Added existing codes within HIT payment system: S9061, S9340, S9341, S9342, S9343, S9370 Clarified existing NDC requirements
Hospital Outpatient Fee Schedule	Annual review; updated template
Inpatient Acute Medical Admission	Effective for discharge dates on or after April 1, 2026: Expanded reimbursement guidelines to include outpatient services rendered within the same facility and/or hospital system as part of the inclusive APR DRG rate
Non-Reimbursable Services	Updated non-reimbursed list for professional providers to remove codes 77439 and 77387
Observation Services	Annual review; updated template
Podiatry	New template; annual review
Radiation Oncology	Removed non-reimbursed status from code 77439
Respiratory Durable Medical Equipment (DME) Services	Added billing information for A4606 and E0445 Annual review; formatting updates Added billing information for replacement PAP devices effective July 1, 2026
Sleep Studies	New template; annual review Added billing information for replacement PAP devices effective July 1, 2026
Telehealth (Telemedicine) - Medical Services	Added billing information and billing examples for place of service codes 02 and 10 effective June 15, 2026 Revised code descriptor for G2211
Telehealth (Telemedicine) – Mental Health	Added billing information and billing examples for place of service codes 02 and 10 effective June 15, 2026 Revised code descriptor for G2211

Payment policy	Updates
Allergy Services	New template; annual review
Chiropractic	New template; annual review
CPT and HCPCS Modifiers	Added RA modifier
Diabetic Care	Annual review; formatting updates Removed prior authorization requirements for codes A4238-A4239, A9277, E2103 Updated Medicare Advantage requirements for codes A4238-A4239
Durable Medical Equipment	Annual review; formatting updates
Evaluation and Management	Revised descriptor for code G2211
Home Infusion	Annual review; updated template Edited to clarify that Blue Cross does not reimburse IV RN or a per diem if the medication administered was billed/paid under the member’s pharmacy benefit Added existing codes within HIT payment system: S9061, S9340, S9341, S9342, S9343, S9370 Clarified existing NDC requirements
Hospital Outpatient Fee Schedule	Annual review; updated template
Inpatient Acute Medical Admission	Effective for discharge dates on or after April 1, 2026: Expanded reimbursement guidelines to include outpatient services rendered within the same facility and/or hospital system as part of the inclusive APR DRG rate
Non-Reimbursable Services	Updated non-reimbursed list for professional providers to remove codes 77439 and 77387
Observation Services	Annual review; updated template
Podiatry	New template; annual review
Radiation Oncology	Removed non-reimbursed status from code 77439
Respiratory Durable Medical Equipment (DME) Services	Added billing information for A4606 and E0445 Annual review; formatting updates Added billing information for replacement PAP devices effective July 1, 2026
Sleep Studies	New template; annual review Added billing information for replacement PAP devices effective July 1, 2026
Telehealth (Telemedicine) - Medical Services	Added billing information and billing examples for place of service codes 02 and 10 effective June 15, 2026 Revised code descriptor for G2211
Telehealth (Telemedicine) – Mental Health	Added billing information and billing examples for place of service codes 02 and 10 effective June 15, 2026 Revised code descriptor for G2211

To download our payment policies, log in and click Find a Payment Policy on the right side of your home page. Or, go to Office Resources>Policies & Guidelines>Payment Policies.

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