By accessing these policies, I acknowledge the following:
Blue Cross and Blue Shield of Vermont’s payment policies:
- Serve as a reference to assist providers and facilities in submitting accurate claims.
- Outline the basis for reimbursement for covered services.
- Apply to services rendered by participating providers.
- Are subject to changes in coding rules and guidelines, such as those established by CPT and HCPCS; there may be instances where coding changes are applied before the policies are amended.
- May be revised from time to time based on state or federal requirements or changes to provider contracts.
BCBSVT payment policies do NOT:
- Provide billing or coding advice.
- Guarantee or determine benefits.
- Control in the event of a conflict with member contracts, provider contracts, medical policies, or claim edits.
- Dictate how other Blue Plans set allowances for care rendered by non-participating providers.
- Constitute medical advice.
Permanent Payment Policy Name
ClaimsXten-Select Edits CPP_32
Home Births CPP_18
Home Infusion Therapy CPP_14
Modifier 22 CPP_06
Modifier 52 CPP_22
Observation Services CPP_07
Provider-Based Billing CPP_11
Urgent Care Clinics CPP_12
In effect until August 31, 2021
Preventive Medicine CPP_26
In effect until December 31, 2021
Telephone Only CPP_24
Telephone Triage CPP_25
In effect until March 31, 2021