This article is for acute care facilities caring for our members
Blue Cross reimburses for outpatient surgical services as outlined in our existing Outpatient Surgical Services – Facility payment policy.
As a reminder, we reimburse outpatient surgical services at a case rate, which reflects the fee for each allowable surgery and services considered included in the allowable reimbursement.
Our current payment policy states that Blue Cross:
As of Q2 2024, services that are not separately reimbursable from the surgical case rate will process in accordance with our existing payment policy. This will help reduce the number of claims that will require a post-payment review.
Be sure to bill:
See our Outpatient Surgical Services – Facility payment policy for additional billing guidelines.
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.
MPC_071223-1P-2