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Billing Guidelines & Resources

Here are some billing guidelines & resources. See our Claim Submission page when you’re ready to submit claims to us. 

 Registered Provider Central users can access additional resources on the site, such as fee schedules.

Billing Specific Services

 Patient Protection and Affordable Care Act Preventive Care Services Billing Guideline
Use this billing guideline for information on certain preventive care services that are available without a cost to members. As always, please check member benefits and eligibility.

 Durable medical equipment

Other Resources

Refer to our General Coding and Billing payment policy () for information regarding:

  • Assistants
  • Locum tenens (when a physician works in place of another physician)
  • Assist at surgery
  • Payment for clinician services in a hospital teaching setting only
  • Modifiers 25, 59, XE, XS, XP, and XU