1.Reimbursement Policy: Consultations (Professional)
Effective 10/31/2021- Empire BCBS policy “Documentation and Reporting Guidelines for Consultations” policy will be renamed as “Consultations” Please remember that this policy will be updated to align with CMS guidance- DOES NOT ALLOW reimbursement for inpatient (99251-99255) or outpatient (99241-99245) consultation codes and requires providers to bill the appropriate office visit Evaluation and Management (E&M) code for consultation services
To read this full reimbursement policy, please click here.
2. NEW Reimbursement Policy (facility): Non-patient Laboratory Services
Effective 10/01/2021- Empire BCBS will implement a new reimbursement policy- Non-Patient Laboratory Services. This policy states that Empire does not allow reimbursement for non-patient laboratory services when reported on a UB-04 with bill type 014X unless provider, state, federal or CMS and/or requirements indicate otherwise.
To read this full reimbursement policy, please click here.
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