Procedure Code and Fee Schedule Updates

Dec. 8, 2020

Additional details have been added for some musculoskeletal codes.

As part of our commitment to help inform our independently contracted providers of certain developments, Blue Cross and Blue Shield of Illinois (BCBSIL) has designated a specific section in the Blue Review to notify you of any significant changes to the physician fee schedules. It’s important to review this area in our provider newsletter each month.

On Jan. 1, 2021, BCBSIL will implement Current Procedural Terminology (CPT®) and Healthcare Common Procedure Coding System (HCPCS) procedure code additions, deletions and revisions. Please note that deleted codes will not be accepted for payment for dates of service on or after Jan. 1, 2021.

Also, effective Jan. 1, 2021, a new reimbursement schedule will be implemented for a select group of musculoskeletal and digestive codes for PPO Area A and Blue Choice PPOSM Area A. Providers that have billed these codes in the past 18 months will receive a letter that describes the program and lists the specific impacted codes. The following codes will not be affected by the new reimbursement schedule: 22551, 22554, 22612, 22614 and 27447.

The information above is not intended to be an exhaustive listing of all the changes. Annual and quarterly fee schedule updates may also be requested by using the Fee Schedule Request Form. Specific code changes that are listed above may also be obtained by downloading the Fee Schedule Request Form and specifically requesting the updates on the codes listed in the Blue Review. The form is available on the Forms page on our Provider website.

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