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December 2020
Billing chart: Blues highlight medical, benefit policy changes
You’ll find the latest information about procedure codes and Blue Cross Blue Shield of Michigan billing guidelines in the following chart.
This billing chart is organized numerically by procedure code. Newly approved procedures will appear under the New Payable Procedures heading. Procedures for which we have changed a billing guideline or added a new payable group will appear under Updates to Payable Procedures. Procedures for which we are clarifying our guidelines will appear under Policy Clarifications. New procedures that are not covered will appear under Experimental Procedures.
You will also see that descriptions for the codes are no longer included. This is a result of recent negotiations with the AMA on use of the codes.
We will publish information about new BCBS groups or changes to group benefits under the Group Benefit Changes heading.
For more detailed descriptions of the BCBSM policies for these procedures, please check under the Medical/Payment Policy tab in Explainer on web-DENIS. To access this online information:
- Log in to web-DENIS.
- Click on BCBSM Provider Publications & Resources.
- Click on Benefit Policy for a Code.
- Click on Topic.
- Under Topic Criteria, click on the drop-down arrow next to Choose Identifier Type and then click on HCPCS Code.
- Enter the procedure code.
- Click on Finish.
- Click on Search.
| Code* |
BCBSM changes to:
Basic Benefit and Medical Policy, Group
Variations Payment Policy, Guidelines
|
| UPDATES TO PAYABLE PROCEDURES |
0017U, 81219, 81270, 81402, 81403, 81450 |
Basic benefit and medical policy
Genetic Testing ̶ JAK2, MPL and CALR Testing for Myeloproliferative Neoplasms policy
The medical policy statement has been updated for the Genetic Testing ̶ JAK2, MPL and CALR Testing for Myeloproliferative Neoplasms policy.
Medical policy statement
The safety and effectiveness of JAK2 testing have been established. It may be considered a useful diagnostic option for patients presenting with clinical, laboratory or pathologic findings suggesting polycythemia vera, essential thrombocythemia or primary myelofibrosis.
The safety and effectiveness of MPL and CALR testing have been established. They may be considered useful diagnostic options for patients presenting with clinical, laboratory or pathologic findings suggesting essential thrombocythemia or primary myelofibrosis.
The use of a targeted genomic panel for hematolymphoid neoplasms may be considered appropriate for the diagnosis and for the selection of the therapy for a myeloproliferative disorder or myelodysplastic syndrome.
The peer-reviewed medical literature hasn’t yet demonstrated the clinical utility for JAK2, MPL and CALR testing in other circumstances. Therefore, these services are considered experimental in all other situations including, but not limited to, the following:
- Diagnosis of nonclassic forms of myeloproliferative neoplasms, or MPNs
- Molecular phenotyping of patients with MPNs
Inclusions:
JAK2 testing as a diagnostic option for patients presenting with clinical, laboratory or pathologic findings suggesting polycythemia vera, essential thrombocythemia or primary myelofibrosis.
Based on World Health Organization criteria, in the case of suspected polycythemia vera, documentation of serum erythropoietin, or EPO, level below the reference range for normal is recommended prior to JAK2 testing. (Refer to the medical policy for the policy guidelines.)
MPL and CALR testing as diagnostic options for patients presenting with clinical, laboratory or pathologic findings suggesting essential thrombocythemia or primary myelofibrosis.
The use of a targeted genomic panel for hematolymphoid neoplasms may be considered appropriate for the diagnosis and for selection of the therapy for a myeloproliferative disorder or myelodysplastic syndrome, as well as targeted therapy.
Exclusions:
JAK2, MPL and CALR testing in other circumstances including, but not limited to, the following:
- Diagnosis of nonclassic forms of myeloproliferative neoplasms, or MPNs
- Molecular phenotyping of patients with MPNs
This policy is effective Nov. 1, 2020. |
38204, 38205, 38206, 38207, 38208, 38209, 38210, 38211, 38212, 38213, 38214, 38215, 38230, 38232, 38240, 38241, 38242, 38243, 81265, 81266, 81267, 81268, 81370, 81371, 81372, 81373, 81374, 81375, 81376, 81377, 81378, 81379, 81380, 81381, 81382, 81383, 86812, 86813, 86816, 86817, 86821, S2140, S2142, S2150 |
Basic benefit and medical policy
BMT-HCT for Hodgkin Lymphoma policy
The safety and effectiveness of autologous or myeloablative allogeneic hematopoietic cell transplantation, or HCT, and reduced-intensity allogeneic HCT have been established. They can be useful therapeutic options for patients with primary refractory or relapsed Hodgkin lymphoma who meet patient selection criteria.
Other uses for HCT are experimental.
The exclusions have been updated to include tandem autologous HCT, effective Jan. 1, 2021.
Inclusions:
Autologous HCT:
- Patients with primary refractory HL
- Patients with relapsed HL
Allogeneic HCT, using either myeloablative or reduced intensity conditioning HCT:
- Patients with primary refractory HL
- Patients with relapsed HL
Exclusions:
- A second autologous cell transplant for relapsed lymphoma after a prior autologous HCT
- Other uses of HCT in patients with HL including, but not limited to, initial therapy for newly diagnosed disease to consolidate a first complete remission
- Tandem autologous HCT
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| POLICY CLARIFICATIONS |
J0584 |
Basic benefit and medical policy
Crysvita (burosumab-twz)
Crysvita (burosumab-twz) is payable for the following updated indication:
- The treatment of tumor-induced osteomalacia in patients 2 years and older
This drug isn’t a benefit for URMBT. |
J3490
J3590 |
Basic benefit and medical policy
Olinvyk (oliceridine)
Effective Aug. 7, 2020, Olinvyk (oliceridine) is covered for the following FDA-approved indications:
Olinvyk (oliceridine) is an opioid agonist indicated in adults for the management of acute pain severe enough to require an intravenous opioid analgesic and for whom alternative treatments are inadequate.
Limitations of use
Because of the risks of addiction, abuse and misuse with opioids, even at recommended doses, reserve Olinvyk for use in patients for whom alternative treatment options (e.g., non-opioid analgesics or opioid combination products):
- Haven’t been tolerated or aren’t expected to be tolerated
- Haven’t provided adequate analgesia or aren’t expected to provide adequate analgesia
The cumulative total daily dose shouldn’t exceed 27 mg.
Dosage and administration
- Use the lowest effective dosage for the shortest duration consistent with individual patient treatment goals.
- Individualize dosing based on the severity of pain, patient response, prior analgesic experience and risk factors for addiction, abuse and misuse.
- Initiate treatment with a 1.5 mg dose.
- For patient-controlled analgesia, or PCA, recommended demand dose is 0.35 mg, with a six-minute lock-out. A demand dose of 0.5 mg may be considered.
- Supplemental doses of 0.75 mg can be administered, beginning one hour after the initial dose and hourly thereafter, as needed.
- Don’t stop Olinvyk in a physically dependent patient.
Dosage forms and strengths
- 1 mg/mL and 2 mg/2 ml (1 mg/mL) in single-dose vials
- 30 mg/30 mL (1 mg/mL) in single-patient-use vial, for PCA use only
This drug isn’t a benefit for URMBT. |
Established
20932, 20933, 20934, 27415, 27416, 28446, 29866, 29867, 29879
Experimental
27899, 29999 |
Basic benefit and medical policy
Autografts and Allografts in the Treatment of focal Articular Cartilage Lesions policy
The medical policy statement has been updated for the Autografts and Allografts in the Treatment of focal Articular Cartilage Lesions policy. This policy is effective Nov. 1, 2020.
Medical policy statement
Microfracture technique
The safety and effectiveness of microfracture surgery in joints (e.g., knee, hip, shoulder) for the treatment of osteochondritis dissecans, or OCD, has been established in patients where OCD is proven.
Osteochondral allografting
The safety and effectiveness of osteochondral allografting to repair large, full-thickness chondral defect of the knee or talus caused by acute or repetitive trauma have been established. It’s a useful therapeutic option for selected patients.
Osteochondral allografting for all other joints is experimental. It hasn’t been shown to improve patient outcomes better than conventional treatment.
Osteochondral autografting
The safety and effectiveness of osteochondral autografting, using one or more cores of osteochondral tissue, has been established for the treatment of symptomatic full-thickness cartilage defects of the knee or talus caused by acute or repetitive trauma in patients who have had an inadequate response to a prior surgical procedure, when the inclusionary criteria are met.
Osteochondral autografting for all other joints and any indications other than those listed above is considered experimental.
Treatment of focal articular cartilage lesions with autologous or allogeneic minced cartilage is considered experimental.
Treatment of focal articular cartilage lesions with decellularized osteochondral allograft plugs (e.g., Chondrofix, TrueFit) is considered experimental.
Treatment of focal articular cartilage lesions with reduced osteochondral allograft discs (e.g., ProChondrix, Cartiform, DeNovo Engineered Tissue, BioCartilage®) is considered experimental. |
69710, 69711, 69714, 69715, 69717, 69718, L8625, L8690, L8691, L8692, L8693, L8694 |
Basic benefit and medical policy
Unilateral or bilateral fully or partially implanted bone-conduction (bone-anchored) hearing aids
The safety and effectiveness of FDA-approved unilateral or bilateral fully or partially implanted bone-conduction (bone-anchored) hearing aids have been established. They may be considered a useful therapeutic option when indicated.
The use of a Baha® Softband may be considered established in children 5 years of age and younger meeting criteria for BAHA treatment, but who are determined to have inadequate skeletal maturity to sustain osteointegration of the Baha device.
Inclusionary criteria have been updated, effective Nov. 1, 2020.
Inclusions:
FDA-approved devices when used according to approved indications and guidelines.
Conductive hearing loss:
FDA-approved unilateral or bilateral fully or partially implantable bone-conduction (bone-anchored) hearing aids may be necessary as an alternative to an air-conduction hearing aid in patients with conductive or mixed hearing loss 5 years of age and older (Baha 4, Baha 5, Baha 5 SuperPower, Baha Cordele II, PontoTM Bone Anchored Hearing System, Ponto 4 and Otomag® Bone Conduction [OBC] devices) or 12 years of age and older (OSIA II system) who also meet one of the following criteria:
- Congenital or surgically induced malformations (e.g., atresia) of the external ear canal or middle ear
- Chronic external otitis or otitis media
- Tumors of the external canal or tympanic cavity
- Chronic dermatitis of the external canal prohibiting the usage of an air conduction hearing aid
And meet the following audiologic criteria:
- A pure-tone average bone-conduction threshold measured at 0.5, 1, 2, and 3 kHz or better than or equal to one of the following:
- 45 dB (OBC and BP100, Baha 4 and Baha 5, Ponto, Ponto 3, Ponto Pro, Ponto Plus, and Ponto 4 devices)
- 55 dB (Intenso, OSIA II, Ponto 3 power, Ponto Pro Power and Ponto Plus Power devices)
- 65 dB (Cordele II, Baha 5 SuperPower, Ponto 3 SuperPower devices).
For bilateral implantation, patients should meet the above audiologic criteria in both ears and have symmetrically conductive or mixed hearing loss as defined by a difference between left and right side bone-conduction threshold of less than 10 dB on average measured at 0.5, 1, 2, and 3 kHz (4 kHz for OBC, Ponto Bone Anchored Hearing System, Ponto 3, Ponto 3 Power, Ponto 3 SuperPower, Ponto 4 and Ponto Pro devices), or less than 15 dB at individual frequencies.
Sensorineural hearing loss:
A unilateral implantable bone-conduction (bone-anchored) hearing aid may be considered medically necessary as an alternative to an air-conduction contralateral routing of signal hearing aid in patients 5 years of age and older (Baha 4, Baha 5, Baha 5 SuperPower, Baha Cordele II, OBC, Ponto 3, Ponto 3 Power and Ponto 3 SuperPower and Ponto Bone Anchored Hearing devices) or 12 years of age and older (OSIA II system) with single-sided sensorineural deafness and normal hearing in the other ear. The pure-tone average air-conduction threshold of the normal ear should be better than 20 dB measured at 0.5, 1, 2, and 3 kHz.
Note: The Audiant® bone conductor is a bone-conduction hearing device. While this product is no longer actively marketed, patients with existing Audiant devices may require replacement, removal or repair.
In patients being considered for implantable bone-conduction (bone-anchored) hearing aid(s), skull bone quality and thickness should be assessed for adequacy to ensure implant stability. Additionally, patients (or caregivers) must be able to perform proper hygiene to prevent infection and ensure the stability of the implants and percutaneous abutments.
Exclusions:
- Other uses of implantable bone-conduction (bone-anchored) hearing aids, including use in patients with bilateral sensorineural hearing loss, are considered experimental.
- Non-FDA-approved devices or indications.
|
69930, 92601, 92602, 92603, 92604, 92605 92606, 92607, 92608, 92609, 92618, L7510, L8614, L8615, L8616, L8617, L8618, L8619, L8621, L8622, L8623, L8624, L8625, L8627, L8628, L8629 |
Basic benefit and medical policy
Cochlear Implant policy
The safety and effectiveness of U.S. Food and Drug Administration‑approved bilateral and unilateral cochlear implants and associated hybrid cochlear implant devices have been established. The implants may be considered useful therapeutic options when indicated.
Inclusionary criteria have been updated, effective Nov. 1, 2020.
Inclusions:
Bilateral or unilateral cochlear implantation is considered an established, safe and effective therapy if all the following criteria are met:
- FDA-approved cochlear implant
- 9 months of age or older
- Bilateral severe to profound pre- or post-lingual (sensorineural) hearing loss
- Defined as a hearing threshold of pure-tone average of 70 dB hearing loss or greater at 500, 1000, 2000 Hz
- Limited or no benefit from hearing aids
Unilateral cochlear implantation is considered established, safe and effective therapy in single-sided deafness, or SSD,a,b when all following are met:
- FDA-approved cochlear implant
- 5 years of age or older
- Profound sensorineural hearing loss in one ear and normal hearing or mild sensorineural hearing loss in the other ear
- Profound hearing loss is defined as having a pure-tone average of 90dB hearing loss or greater at 500 Hz, 1000 Hz, 2000 Hz and 4000 Hz. Normal hearing is defined as having a PTA of up to 15 dB HL at 500 Hz, 1000 Hz, 2000 Hz and 4000 Hz. Mild hearing loss is defined as having a PTA of up to 30 dB HL at 500 Hz, 1000 Hz, 2000 Hz and 4000 Hz. Mild to moderately severe hearing loss is defined as having a PTA ranging from 31 to up to 55 dB HL at 500 Hz, 1000 Hz, 2000 Hz and 4000 Hz.
aIndividuals with single sided deafness, or SSD, or asymmetrical hearing loss, or AHL, must obtain limited benefit from an appropriately fitted unilateral hearing aid in the ear to be implanted. For individuals ages 18 and older, limited benefit from unilateral amplification is defined by test scores of 5% correct or less on monosyllabic consonant-nucleus-consonant, or CNC, words in quiet when tested in the ear to be implanted alone. For individuals between ages 5 and 18, insufficient functional access to sound in the ear to be implanted.
bAHL is defined as a profound sensorineural hearing loss in one ear and mild to moderately severe sensorineural hearing loss in the other ear, with a difference of at least 15 dB in pure tone averages, or PTAs, between ears.
Replacement of internal or external components in a small subset of members may be considered established when all the following are met:
- There’s an inadequate response to existing components to the point of one of the following:
- Interfering with the individual’s activities of daily living.
- The components are no longer functional and can’t be repaired.
- Copies of original medical records must be submitted, either hard copy or electronically, to support medical necessity.
Cochlear implant with a hybrid device that includes the hearing aid integrated into the external sound processor of the cochlear implant (e.g., the Nucleus® Hybrid L24 Cochlear Implant System) may be considered established for patients 18 years and older who meet all of following criteria:
- Bilateral severe-to-profound high frequency sensorineural hearing loss with residual low-frequency hearing sensitivity
- Receive limited benefit from appropriately fit bilateral hearing aids
- Have the following hearing thresholds (must meet all):
- Low frequency hearing thresholds no poorer than 60 dB hearing level up to and including 500 Hz (averaged over 125, 250, and 500 Hz) in the ear selected for implantation
- Severe to profound mid-to-high frequency hearing loss (threshold average of 2000, 3000, and 4000 Hz ≥75 dB hearing level) in the ear to be implanted
- Moderately severe to profound mid-to-high frequency hearing loss (threshold average of 2000, 3000, and 4000 Hz ≤ 60 dB hearing level) in the contralateral ear
- Aided consonant-nucleus-consonant word recognition score from 10% to 60% in the ear to be implanted in the preoperative aided condition and in the contralateral ear will be equal to or better than that of the ear to be implanted but not more than 80% correct.
In certain situations, implantation may be considered before age 9 months. One scenario: Post-meningitis when cochlear ossification may preclude implantation. Another scenario is in cases with a strong family history, because establishing a precise diagnosis is less uncertain.
Contraindications to cochlear implantation may include deafness due to lesions of the eighth cranial (acoustic) nerve, central auditory pathway or brainstem; active or chronic infections of the external or middle ear; and mastoid cavity or tympanic membrane perforation. Cochlear ossification may prevent electrode insertion, and the absence of cochlear development as demonstrated on computed tomography scans remains an absolute contraindication.
Exclusions:
- Upgrades of an existing, functioning external system to achieve aesthetic improvement, such as smaller profile components or a switch from a body-worn, external sound processor to a behind-the-ear model
- Replacement of internal or external components solely for the purpose of upgrading to a system with advanced technology or to a next-generation device
- Non-FDA approved devices or indications
|
Telemedicine – Synchronous
99441, 99442, 99443, 99421, 99422, 99423, any CPT code that is appropriate for both the encounter and provider scope.
Experimental
H0031, H0032, H2014, H2019, 0362T, 97151, 97152, 97153, 97154, 97158
Telemedicine asynchronous (store and forward)
99446, 99447, 99448, 99449, 99451
99452, G2010
Behavioral health codes
Established only the following codes:
96130 and 96156
Behavioral health codes
Other codes: (experimental, not medically necessary, etc.)
All CPT codes related to behavioral health care, other than those listed under “Established” |
Basic benefit and medical policy
Telemedicine Services policy
The criteria have been updated for the Telemedicine Services policy. Historically, telemedicine, a subset of telehealth, has been defined as the use of telecommunications technology for real-time, medical diagnostic and therapeutic purposes when distance separates the patient and health care provider.
In June 2020, influenced by the COVID-19 pandemic, the State of Michigan expanded the definition of telemedicine to include store and forward (asynchronous) as well as real-time (synchronous) interactions.
With this expanded definition, telemedicine now includes the synchronous and asynchronous delivery of care between a patient and provider, or between provider and provider. Telemedicine may substitute for a face-to-face, hands-on encounter between a patient and the health care provider when using the appropriate technology.
The safety and effectiveness of telemedicine (synchronous or asynchronous care) have been established. It may be considered a useful diagnostic and therapeutic option when indicated.
Inclusions:
Synchronous (real-time encounter)
- The provider must be licensed, registered or otherwise authorized to perform service in their health care profession in the state where the patient is located. Services must fall within their scope of practice.
- Telemedicine delivered services are available to all clinicians; however, this may not be the preferred method of delivery in certain clinical scenarios, for example chronic suicidal ideation or unstable angina. A hosted visit** or a face-to-face visit may be necessary due to the complexity of the clinical situation. The telemedicine provider may provide the face-to-face encounter.
- Telemedicine delivered services for ongoing treatment of a condition that is chronic or is expected to take more than five sessions before the condition resolves or stabilizes may require a hosted visit** or a face-to-face visit. The telemedicine provider may provide the face-to-face encounter.
- The service must be conducted over a secured channel.**
- The delivery of the service can be either audio only (telephone) or audio/video (a secured computer-based system).
**See Policy Guidelines
Online visit
- An audio-visual online communication
- The patient initiates the medical or behavioral health encounter
- The provider must be licensed, registered or otherwise authorized to perform service in their health care profession in the state where the patient is located.
- A low-complexity, straightforward decision-making encounter that addresses urgent but not emergent clinical conditions
- A single encounter where a follow-up encounter isn’t anticipated
- Services must fall within the provider’s scope of practice.
Asynchronous (store and forward encounter)
- The provider must be licensed, registered or otherwise authorized to perform service in their health care profession in the state where the patient is located. Services must fall within their scope of practice.
- The patient data (pre-recorded videos, digital images such as X-rays or photos, test results or any other information necessary for the evaluation) must be transmitted over a secured channel.**
- Behavioral health services allowed as asynchronous care are limited. (See the Billing Guidance and Code sections.)
**See Policy Guidelines.
Exclusions – synchronous and asynchronous:
- Request for medication refills
- Reporting of normal test results
- Provision of educational materials
- Scheduling of appointments and other health care related issues
- Registration or updating billing information
- Reminders for health care related issues
- Referrals to other providers
- An online or telemedicine visit resulting in an office visit, urgent care or emergency care encounter on the same day for the same condition
- An online visit for the same condition of an online visit within the previous seven days
- An online or telemedicine visit occurring during the post-operative period
Applied behavioral analysis for the treatment of autism spectrum disorder is considered experimental when delivered by telemedicine (synchronous and asynchronous care).**
**Exceptions:
- Parent/guardian/caregiver adaptive behavior treatment training (97156, 97157, S5111, S5108) may be performed as a telemedicine service.
- Program modification of ABA therapy (97155) may be used as a combination of face-to-face and telemedicine services up to 50% of the time – as long as a technician is present face to face.
Note: Please refer to the medical policy for the Policy Guidelines.
The guidelines:
- Define who is an eligible provider
- Explain how we cover applied behavior analysis therapy for autism spectrum disorder
- Outline expectations for secure communication with patients
- Provide information regarding appropriate billing (e.g., an originating site is no longer required)
This policy is effective Nov. 1, 2020. |
J3490
J3590 |
Basic benefit and medical policy
Byfavo (reminazolam)
Effective July 2, 2020, Byfavo (reminazolam) is covered for the following FDA-approved indications:
Byfavo (remimazolam) for injection is a benzodiazepine indicated for the induction and maintenance of procedural sedation in adults undergoing procedures lasting 30 minutes or less.
Dosage and administration
Individualize and titrate BYFAVO dosing to desired clinical effect.
Adult patients:
- Administer an initial dose intravenously as a 5 mg push injection over a one-minute time period.
- If necessary, administer supplemental doses of 2.5 mg intravenously over a 15-second time period. At least two minutes must elapse prior to the administration of any supplemental dose.
ASA-PS III-IV patients (at the discretion of the physician):
- Based on the general condition of the patient, administer 2.5 mg to 5 mg over a one-minute time period.
- If necessary, administer supplemental doses of 1.25 mg to 2.5 mg intravenously over a 15-second time period. At least two minutes must elapse prior to the administration of any supplemental dose.
Dosage forms and strengths
Each glass, single-patient-use vial contains 20 mg BYFAVO (remimazolam) lyophilized powder for reconstitution, equivalent to 27.2 mg remimazolam besylate.
This drug isn’t a benefit for URMBT. |
J7298 |
Basic benefit and medical policy
Mirena (levonorgestrel-releasing intrauterine system)
Effective Aug. 20, 2020, Mirena (levonorgestrel-releasing intrauterine system) is covered for the following FDA-approved indications:
- Prevention of pregnancy for up to 6 years
- Treatment of heavy menstrual bleeding for women who choose to use intrauterine contraception as their method of contraception for up to five years.
Dosage and administration
- Initial release rate of levonorgestrel (LNG) is 20 mcg/day; this rate is reduced to about 10 mcg/day after 5 and 9 mcg/day after 6 years.
- To be inserted by a trained health care provider using strict aseptic technique. Follow insertion instructions exactly as described.
Patient should be re-examined and evaluated four to six weeks after insertion; then, yearly or more often if indicated. |
| EXPERIMENTAL PROCEDURES |
43644, 43645 |
Basic benefit and medical policy
Gastric bypass surgery for gastroparesis
Gastric bypass surgery for gastroparesis is experimental. This procedure hasn’t been scientifically demonstrated to be as safe and effective as conventional treatment.
The policy effective date is Nov. 1, 2020. |
64999, C9757 |
Basic benefit and medical policy
Annular closure devices
The use of annular closure devices (e.g., Xclose®, Barricaid®, DART system, Inclose™) is experimental. It hasn’t been clinically demonstrated to be as safe and effective as conventional treatment.
This policy is effective Nov. 1, 2020. |
| GROUP BENEFIT CHANGES |
AJM Packaging |
AJM Packaging, group number 71395, is offering the plans below, effective Jan. 1, 2021.
Group number: 71395
Alpha prefixes: PPO (PYJ), Medicare PPO (PZJ)
Platform: NASCO Hybrid
Plans offered:
PPO medical/surgical
Dental
Vision
Prescription drug |
Meijer |
Effective Jan. 1, 2021, all Meijer plans are moving to an Exclusive Provider Organization, or EPO. In addition, Meijer has implemented the High-Performance Network, or HPN. The HPN is offered as an additional option to existing plans and not as a full replacement. For more details, see the article in this issue of The Record.
Group number: 72625
Alpha prefixes:
EPO (MJE)
EPO WI Select Network (OLI)
EPO High Performance Network (MNK)
Platform: NASCO
Plans offered: All plans are EPO and include hearing:
EPO — Advantages Health with HSA
EPO — Health Select with HRA
HPN — Advantages Health with HSA
HPN — Health Select with HRA
|
Stock X LLC |
Stock X LLC (former group number 71809) is leaving the Rock Central (group number 71544) umbrella and becoming its own group/entity.
Group number: 71822
Alpha prefix: PPO (JXP)
Platform: NASCO
Plans offered:
PPO medical/surgical
Prescription drug
CDH — HSA
Hearing |
|
