We’re making a professional payment policy change for select procedures done in ambulatory surgical facilities

Blue Cross Blue Shield of Michigan recognizes that for certain procedures, additional effort is required and additional costs are incurred when performed outside of a hospital setting. Starting Feb. 1, 2021, the PPO physician reimbursement policy will increase allowed amounts by 15% for select procedures when done in an ambulatory surgical facility. For a preliminary list of the CPT codes for these procedures, click here.

Note: This is in addition to the procedures identified in the May 2020 Record article, with payment policy that was adjusted in July 2020.

We’ll continue to closely monitor our list of eligible procedures and adjust it based on provider input and other factors, including the effectiveness of the policy. Any other procedures not listed will be paid at the published rate.