Fee Schedule

We value our business relationships with all providers who are already participating in our Preferred Provider Option (PPO), Blue Choice PPOSM, Blue Choice PreferredSM, Blue Choice SelectSM, and Blue High Performance Network® (BlueHPN®) networks. We are also pleased to welcome new providers on board.

Fee schedules—BCBSIL’s Schedule of Maximum Allowances—are a key component of your contractual relationship with BCBSIL, and we want to help ensure that you always have the most up-to-date information.

  • To review BCBSIL’s Schedule of Maximum Allowances for PPO and Blue Choice PPO providers, you may submit a Fee Schedule Request Form to BCBSIL via fax, along with a signed Confidentiality Agreement.
  • Significant changes to the physician fee schedules are included in the Blue Review provider newsletter.
  • Specific code changes and annual and quarterly fee schedule updates can be obtained by downloading and submitting a Fee Schedule Request Form.
  • Professional providers participating in our PPO, Blue High Performance and Blue Choice PPO networks may use the Fee Schedule Listing tool on Availity® Essentials to submit electronic requests and receive the contracted price allowance for specific codes.

Note: Illinois Medicaid and Medicare fee schedules are located on the HFS and CMS websites.

National Drug Code (NDC) Reimbursement Schedule

Providers participating in our PPO and Blue Choice PPO networks may access and obtain the NDC Reimbursement Schedule by using the Plan Documents Viewer via Availity Essentials.

 

Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSIL. BCBSIL makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.