This article is for acute care hospitals caring for our members
During the COVID-19 Federal Public Health Emergency (PHE), COVID-19 laboratory services were reimbursed separately when billed with an outpatient surgical procedure. Starting in Q4 2023, COVID-19 laboratory services will no longer be separately reimbursed when billed with an outpatient surgical procedure. We will include reimbursement for the laboratory services in the outpatient surgical service’s case rate. This update aligns with the expiration of the COVID-19 Federal PHE earlier this year and Blue Cross’ existing payment policy.
As a reminder, Blue Cross reimburses outpatient surgical services at a case rate, which reflects the fee for each allowable surgery, including laboratory services directly related to the surgery. Refer to our Outpatient Surgical Services – Facility payment policy for additional information. To download this policy, log in and go to Office Resources>Policies & Guidelines>Payment Policies.
Questions?
If you have any questions, please contact 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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