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April 2019

Blue Cross changing practitioner fees July 1

Blue Cross Blue Shield of Michigan will change practitioner fees with dates of service on or after July 1, 2019. This change applies to services provided to our Traditional, TRUST and Blue Preferred PlusSM members, regardless of customer group.

Blue Cross will use the 2019 Medicare resource-based relative value scale for most relative value unit-priced procedures for dates of service on and after July 1. Most fees are currently priced using the 2018 values. Keep in mind that the Physician Group Incentive Program allocation of professional fees will remain unchanged this year. The entire adjustment of 1.5 percent will be directed toward increasing the funding of value-based reimbursement, or VBR.

Also, the conversion factor used to calculate anesthesia base units for anesthesia procedures will increase by 1.5 percent.

Fee schedules that are effective July 1 will be available on web-DENIS on April 1. To find fee schedule information, go to the homepage of web-DENIS and follow these steps:

  1. Click on BCBSM Provider Publications and Resources.
  2. Click on Entire Fee Schedules and Fee Changes, which will bring up the End User Agreement.
  3. Click on Accept.

Only claims submitted with dates of service on or after July 1 will be reimbursed at the new rates.

Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and
independent licensees of the Blue Cross and Blue Shield Association.