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Latest Information on the E&M Commercial Reimbursement Policy

BCBS of NC recently published an update explaining the E&M commercial reimbursement policy related to the reduction in payment of Problem Oriented Evaluation and Management Related Services when submitted on the same date as a Preventive Medicine or Annual Wellness encounter.  The new policy will be effective as of September 8, 2022. 


Due to technical issues claims submitted for dates of service between June 1, 2021 and September 7, 2022 will not be subject to the updated E&M commercial reimbursement policy. Claims submitted for dates of service September 8, 2022 and beyond will process in alignment with the updated policy.


If you have received a request for recoupment, please disregard at this time. If you have submitted a refund in response to a request from BCBS, more details will be shared soon on the process for reversing your payment. 


Click here for more information.