CS modifier limited to specific codes that result in COVID-19 testing for commercial plans, effective Sept. 1

To make provider billing practices more uniform, Blue Cross Blue Shield of Michigan and Blue Care Network commercial plans will limit the use of the CS modifier to a list of codes that is similar to the list published by the Centers for Medicare & Medicaid Services on Feb. 4, 2021. This change for our commercial plans will go into effect with dates of service on or after Sept. 1, 2022.

The CS modifier identifies that the services resulted in a COVID-19 test and are subject to the member cost-sharing waiver during the public health emergency.

Effective with dates of service on or after Sept. 1, 2022, for Blue Cross and BCN commercial plans, you should only bill the CS modifier with one of the procedure codes on the Services that result in a COVID-19 test and the CS modifier document. We will only waive member cost share when the CS modifier is billed with one of these codes.

As a reminder, the procedure code may not be eligible for the member cost-sharing waiver if you bill with a diagnosis code that indicates the service was administrative or routine, such as an examination for an employer, school, sports team or research study. Always check the member’s eligibility and benefits.

You should follow CMS guidance for our Medicare Advantage plans, Medicare Plus Blue℠ and BCN Advantage℠. If you submit a CS modifier with a procedure code that’s not allowed by CMS for one of our Medicare Advantage members, the claim will be denied. The latest CMS code list is available as part of this CMS guidance.**

Reminder: These claims are subject to a post-service review (audit).

We’ve updated the COVID-19 patient testing recommendations for physicians document, which can be found on our new provider portal or our public website as follows.

Our provider portal:

Log in to our provider portal (availity.com**) and follow these steps:

1. Click on Payer Spaces in the menu bar.
2. Click on the BCBSM and BCN logo.
3. Click on the Resources tab.
4. Click on Secure Provider Resources (Blue Cross and BCN).
5. Under Easy Access, click on Coronavirus information.

Our public website:

Visit our COVID-19 webpage for health care providers.

**Blue Cross Blue Shield of Michigan and Blue Care Network don’t own or control this website.