Additional procedures codes payable to OPC providers for Blue Cross commercial members, starting July 1

For members with Blue Cross Blue Shield of Michigan commercial plans, we’ve updated our systems to make additional services payable to providers at outpatient psychiatric care facilities.

For dates of service on or after July 1, 2022, the following procedure codes will be payable to the OPC providers specified below for Blue Cross commercial members:

This change brings the list of procedure codes that are payable to OPC providers for Blue Cross commercial members more in line with those that are payable to OPC providers for Blue Care Network members.

Billing instructions

When billing these procedure codes, include the following in the order specified below:

1. The modifier that indicates the licensure level (level of care) for the rendering provider (such as: AH, AJ, HO)
2. If the service was delivered via telemedicine: The telemedicine modifier (either GT or 95)
3. The place of service:
• If the service was delivered in person: Include place of service 11.
• If the service was delivered via telemedicine: Include place of service code 11, 02 or 10.

To view detailed billing instructions for services delivered via telemedicine, see the “Billing telehealth visits” section of the Telehealth for behavioral health providers document. Refer to the “Outpatient psychiatric care facilities” subsection.

By July 1, we’ll update the Telehealth for behavioral health providers document to reflect the additional codes that are payable for Blue Cross commercial members.

Blue Cross commercial OPC fee schedule

By July 1, we’ll update the OPC fee schedule to reflect this change. You can access the fee schedule as follows:

1. Log in to our provider portal (availity.com**).
2. Click on Payer Spaces on the Availity menu bar.
3. Click on the BCBSM and BCN logo.
4. Click on Secure Provider Resources (Blue Cross and BCN) on the Resources tab.
5. Choose Fee Schedules > Blue Cross Facility Fee Schedules.
6. If prompted, accept the End User License Agreement.
7. Click on Outpatient Psychiatric Care on the left.
8. Click on the link to open the 2022 fee schedule.

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