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Rendering Provider Fee Schedule Notification Update

September 14, 2011 (Updated 10/17/11)

Effective Dec. 12, 2011, Blue Cross and Blue Shield of Illinois will implement a fee schedule change that will provide reimbursement based on the type of rendering provider indicated on the claim. The provider types listed below will have the differentials applied to the Schedule of Maximum Allowance as noted:   

100% of the Schedule of Maximum Allowances (SMA)

  • Physician 

85% of the SMA

  • Licensed Clinical Psychologist
  • Certified Nurse Specialist - Updated 10/17/11
  • Certified Nurse Practitioner
  • Certified Registered Nurse Anesthetist
  • Certified Nurse Midwife
  • Physician Assistant - Updated 10/17/11

85% of the 20% of the SMA

  • Certified Surgical Assistant
  • Physician Assistant (when performing assist at surgery) - Updated 10/17/11

70% of the SMA

  • Licensed Clinical Social Worker
  • Licensed Clinical Professional Counselor
  • Licensed Marriage and Family Therapist