Posted in Insurance, Updates

Empire BCBS New Reimbursement Policy for services provided by NP or/and PA

Empire Introduces a new reimbursement policy Effective Date 09/01/2020 for services done by Nurse Practitioner and Physician Assistant Providers.

Unless indicate otherwise by state, federal, or CMS contracts and/or requirements; Empire BCBS will reimburse NPs and PAs for services done on DOS 09/01/2020 and thereafter.

The reimbursement is based upon the following:

1. The services performed by NP or PA are in the scope physician’s office

2. The service is considered a physician’s services

3. A payment reduction consistent with CMS reimbursement

The services furnished, should be billed under the NP or PA own NPI number.

Modifier: SA

Please click here to visit the complete new reimbursement policy.

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My name is Kate Patskovska, CPB. I am an Independent Medical Biller CPB (AAPC), AAPV Approved Instructor; and an owner of KR2 Medical Billing. I create educational material including blogs, presentations that focus on topics of medical billing, medical coding and reimbursement in healthcare.

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