Posted in #Medicareadvantage, BCBS (Various States), Training, Updates

BCBS of MN: Reimbursement update (modifiers 52, CO, CQ)

Please note which type of providers will be affected by each reimbursement policy for specific modifiers and the effective date it begins.


The following reimbursement updates take effect as of July 1, 2022:

  1. Modifier 52- for services performed on 07/01/2022 and thereafter, Blue Cross will be begin reimbursing procedure codes billed with a -52 modifier at the lesser of 50% of the physician fee schedule allowance or charge submitted for the following lines of business: • Commercial• Federal Employee Program (FEP)
  2. The Reimbursement Policy, General Coding – 003 Coding Edits will be updated to reflect this change.

PT/OT/ST services reimbursement with modifiers CO, CQ for DOS 07/01/2022 and thereafter:

  1. Commercial plans-

Blue Cross will be implementing a 15% reduction in the allowed amount for services
modified with CO or CQ modifier for professional providers.

The following reimbursement Policy took affect for DOS 01/01/2022 and thereafter

1. Medicare Advantage Plans-

Blue Cross implemented a 15% reduction in the allowed amount for services modified with CO or CQ modifier for professional and facility providers to comply with requirements of the Centers for Medicare & Medicaid Services (CMS).


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Posted in BCBS (Various States), Training

BCBS of Minnesota: Medical and Pharmacy benefit updated 09/05/2022

The following prior authorization changes apply to BCBS of Minnesota Commercial and/or Medical Advantage Plan types.


The changes will take affect on 09/05/2022 and for all of the DOS thereafter.

If you are physician that provides above mentioned services to the BCBS of MN members of commercial and/or medicare advantage plans and you have questions,
please contact provider services at (651) 662-5200 or 1-800-262-0820.


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Empire BCBS Ohio: new AIM Specialty Health phone numbers

If you are a physician that is accepts Empire BCBS Ohio members and requests services through AIM Specialty Health then this blog post is for you!

The following AIM Specialty Health phone numbers are effective 04/01/2022

StateAIM phone number
effective April 1, 2022
Indiana(833) 775-1952
Kentucky(833) 419-1357
Missouri(833) 305-1807
Ohio(833) 404-1678
Wisconsin(833) 342-1253

The old AIM Specialty Health Numbers will NO LONGER be active on August 15, 2022 and thereafter.


Physicians are encouraged to utilize self service via AIM is to use the ProviderPortalSM .

There physicians can:

  • Check order status and view order history
  • Print/save PDF of order summary
  • Use multiple staff members to enter/view the practice’s orders
  • Increase payment certainty
  • Reference desk training and tutorials, including clinical criteria and CPT lists

To register your practice in ProviderPortal. If you are not already registered, go to providerportal.com to register.


Find this type of contact useful? Follow my blog for more medical billing and coding guideline changes, insurance network updates, medical and reimbursement policy changes and more!


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