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Reminder: Bill E/M services with professional revenue codes
March 1, 2022

This article is for acute care facilities caring for our members

Blue Cross reimburses for evaluation and management (E/M) services as outlined in our existing Outpatient Clinic Services – Facility Payment Policy.

As a reminder, we only reimburse E/M services in a facility setting when billed with professional revenue codes.

Our existing Outpatient Clinic Services – Facility Payment Policy states the following:

  • Blue Cross reimburses E/M services billed with a professional revenue code only.
  • Blue Cross does not reimburse facility charges for E/M services performed in any outpatient setting.

Payment policy application

In Q2 2022, we will have the ability to process claims in accordance with this payment policy pre-payment. We will also enforce our existing policy through post-payment reviews.

See our payment policy for additional reimbursement and billing guidelines.


Call Provider Service at 1-800-882-2060. As always, thank you for the care you provide to your patients—our members.


Outpatient Clinic Services – Facility Payment Policy (log in and go to Office Resources>Policies & Guidelines>Payment Policies).