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Updated payment policies now available
March 31, 2023

This article is for all providers caring for our members

The following payment policies, updated in Q1 2023, are now available on Provider Central.

Payment policy Updates
Acupuncture
  • Annual review; no updates
Advance Care Planning
  • Annual review; no updates
COVID-19 Public Health Emergency temporary payment policy
  • Revised description of 0134A
Diabetic Care
  • Annual review
  • Added HCPCS A4238 to coding grid
Durable Medical Equipment
  • Annual review
  • Updated pharmacy information for V-GO insulin delivery device
Family Planning
  • Annual review
  • Updated comment section in coding grid for Liletta
Incident To Billing for Supervising Providers for Mental Health Services - Professional
  • Edited to clarify that notes must be reviewed and signed by the supervising provider within 3 business days of the service performed
Non-Reimbursable Services
  • Updated links to non-reimbursed list for professional providers and non-reimbursable list for facility providers
Outpatient Surgical Services - Facility
  • Annual review; template update
  • Edited to clarify accessing CMS status indicator N procedure codes
Radiology
  • Updated FY modifier reimbursement information
Radiology- Multiple Imaging
  • Annual review
  • Added documentation of existing Category III CPT codes and G0279 to coding grid
  • Updated FY modifier reimbursement percentage consistent with CMS
Respiratory Durable Medical Equipment (DME) Services
  • Annual review
  • Updated A7039 limit
Sleep Studies
  • Annual review; template update
  • Edited for clarity
Telehealth (Telemedicine) – Medical Services
  • Revised reimbursement information for primary care providers and chronic diagnosis claims to remove reduction effective July 1, 2023. Blue Cross will continue to pay these services at parity

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.

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