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BCBS to Adopt New Payment Methodology Dec. 1, 2009

For PMD doctors, Blue Cross of Alabama will adopt a new payment methodology effective December 1, 2009.  They will implement the Resource Based Relative Value Scale (RBRVS) which is being used by the majority of payers across the nation.  The BCBS transition to RBRVS will occur over several years.

In addition, BCBS will replace their fragmented coding edits with the National Correct Coding Initiative (NCCI) standards.

These changes will increase payment on some CPT codes and decrease others.  Overall, BCBS does not expect a change in the total PMD network payout.  This transition is expected to have greater emphasis on the non-procedural component of patient care especially for Primary Care.  In addition, the adoption of these national claims filing standards should result in efficiencies for standard claim submissions.

Providers can now locate the new PMD fee schedule and payment methodology changes at through Provider Access login. For more information refer to: