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:
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).