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Reminder: Incidentals related to emergency room visit
October 31, 2023

This article is for acute care hospitals caring for our members

Blue Cross reimburses for emergency room services as outlined within our existing Emergency Room - Facility payment policy.

As a reminder, our payment policy states that Blue Cross:

  • Reimburses emergency room services, which include:
    • Room and facility charges that are directly related to the emergency, or
    • Procedures performed in the emergency room, such as surgeries, treatments, and therapies.
  • Separately reimburses ancillary services performed during an emergency room visit, such as laboratory and radiology work.
  • Does not separately reimburse for services, products, or drugs considered incidental to the emergency procedure performed.

Payment policy application

Starting in Q1 2024, we will process claims pre-payment in accordance with our existing policy and will no longer separately reimburse services, products, or drugs considered incidental to the emergency room procedure performed. As a result, this will help reduce the number of claims that need post-payment review.


  • Emergency Room - Facility payment policy

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.


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.