February 17, 2023
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.
Effective March 1, 2023, we will update select immunizations, vaccines and toxoids in the 90281-90396 and 90476- 90759 Current Procedural Terminology (CPT®) code ranges. Please note that not all CPT codes in this range will be affected.
FEE SCHEDULE UPDATE:
Effective June 1, 2023, BCBSIL will launch its annual update of the Schedule of Maximum Allowances (SMA) including Durable Medical Equipment (DME) supplies, prosthetics, orthotics and clinical laboratory codes. This fee schedule update takes into consideration the revisions made by the Centers for Medicare & Medicaid Services (CMS) to the resource based relative value scale. Reimbursement for services provided on or after June 1, 2023, will be based on the updated fee schedule. This update affects PPO and Blue Choice PPOSM fee schedules for professional providers. Providers may request fee schedules for this update starting May 30, 2023.
The information above is not intended to be an exhaustive listing of all changes. For more information on the above change(s), use our Fee Schedule Request Form and specifically request the updates on the codes listed in the Blue Review. Annual and quarterly fee schedule updates may be requested by using the Fee Schedule Request Form. The downloadable form is available on the Forms page on our Provider website. Professional providers participating in our Preferred Provider Option (PPO) and Blue Choice PPOSM networks may use the Fee Schedule Listing tool on Availity® Essentials to submit electronic requests and receive the contracted price allowance for specific codes.
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