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, 2020. This change applies to services provided to our Traditional, TRUST and Blue Preferred Plus^SM members, regardless of customer group.

Blue Cross will use the 2020 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 2019 values. Keep in mind that the Physician Group Incentive Program allocation of professional fees will remain unchanged this year. The entire adjustment of 2.0% will be directed toward increasing the funding of value-based reimbursement.

In addition, the conversion factor used to calculate approved amounts in Blue Cross’ anesthesia fee structure will increase to $63.76. Also, the anesthesia base units for CPT code *00812 (anesthesia for procedures on the lower abdomen) used in the same fee structure will be reduced from “4” to “3.”

Fee schedules 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.