This article is for contracted Medicare Advantage acute care facilities caring for our members
As a reminder for Medicare Advantage claims, please bill inpatient and outpatient facility services to Blue Cross as you would to the Centers for Medicare & Medicaid Services (CMS). Blue Cross applies Medicare equivalent pricing, including CMS payment adjustments.
For example, you should bill HCPCS code G0463 with modifier PO for outpatient clinic visits rendered at an off-campus location of a hospital.
Please refer to our Medicare Advantage acute care facility payment policy for situations where Blue Cross does not align with CMS.
To download our payment policies, log in and click Find a Payment Policy on the right side of your home page. Or log in and go to Office Resources>Policies & Guidelines>Payment Policies.
Questions?
If you have any questions, please call Network Management and Credentialing Services at 1-800-316-BLUE(2583). As always, thank you for the care you provide to our members.
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