Notification from BCBS KC regarding the Physician Fee Schedule for the Participating/Traditional Plans:
“For dates of service beginning on and after September 1, 2015, the Participating Fee Schedule will reflect 100 percent of the 2014 Medicare RBRVS schedule of relative value units and 100 percent of the 2014 Medicare clinical lab fee schedule. Additionally, Blue KC will reimburse specific CPT/HCPCS codes based on the site-of-service where the service is performed. This change was already made effective May 1, 2013, for all other networks and makes the participating methodology consistent with all other network agreements currently in place.”
We did clarify, this only applies to the Traditional member policies which currently has about 36,000 member enrollment compared to one of their PPO member enrollment of 620,000, so this will impact a small population. We also verified, the rate change will not affect anesthesia services, only fee-for-service procedures (i.e. injections, etc.).
abinsights Contact Information
abinsights readers are invited to submit comments, questions, tips, and suggestions for articles on any subject related to billing, collections, coding, reimbursement, and compliance. Send to: Anesthesia Billing, Inc., P O Box 388, Newton, KS 67114-0388. Phone 316-281-3700. Fax 316-282-4322.
Our purpose is to help you meet inevitable challenges. We hope to deliver practical knowledge and solutions drawn from top resources and business publications in every issue, knowledge you can use today.
Reasonable attempts have been made to be accurate. However, medical billing, collections, coding and compliance are part science, part art, and even experts sometimes differ. Neither Anesthesia Billing, Inc., the editors, publisher, contributors, or consultants warrant or guarantee the information contained will be applicable or appropriate in all situations. For information specific to your practice, consult a qualified professional.
The information included in this publication is provided, among other things, to alert you to legal developments and should not be considered legal advice. Specific questions about how this information affects your particular situation should be addressed to your attorney.
Editor: Philip Blann (pblann@anesthesiabilling.com).
No Comments