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. To download this policy, log in and go to Office Resources>Policies & Guidelines>Payment Policies.
As a reminder, we reimburse outpatient surgical services at a case rate, which reflects the fee for each allowable surgery, including diagnostic services directly related to the surgical procedure.
Our payment policy states that Blue Cross:
Effective Q3 2023, we will process claims in accordance with our Outpatient Surgical Services — Facility payment policy.
Be sure to bill:
See our Outpatient Surgical Services – Facility payment policy for additional billing guidelines.
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.
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