- Home
- " > Find a doctor
- sitemap
- Contact us
- About us
- Contracting and credentialing
- Claims and payment
- BlueCard Program
- Identifying members
- Claims submission
- Receiving payment
- Electronic transactions
- Library
- Administrative Manual
- Electronic tools
- Forms
- News and updates
- Policies and guidelines
- Reimbursement Policy
- Table of contents
- DME Reimbursement
- DME Reimbursement Medicare Advantage
- Hospital Acquired Conditions and Never Events
- Incidental Procedures
- Inpatient Hospital Readmissions
- Inpatient Hospital Readmissions Medicare Advantage
- Medicare-based Fee Effective Dates
- Medicare-based Fee Effective Dates - Medicare Advantage
- Bundling Edits
- Non-reimbursable Services
- Pricing Codes Without RVUs
- Injection and Infusion Services
- Anesthesia Reimbursement
- Anesthesia Reimbursement Medicare Advantage
- Anesthesia Services Reporting
- Drugs and Radiopharmaceuticals Reimbursed Under Medical Coverage
- Maternity Care
- New Patient Visit
- Global Days
- Modifier 22 Increased Procedural Services
- Modifier 25 Significant Separately Identifiable E&M Service
- Modifier 26 Professional Component Modifier TC
- Modifier 50 Bilateral Procedure
- Modifier 51 and Multiple Procedure Logic
- Modifier 53 Discontinued Procedure
- Modifier 54; Surgical Care Only; Modifier 55; Postoperative Management Only; Modifier 56; Preoperative Management Only
- Modifier 57 Decision For Surgery
- Modifiers 59, XE, XP, XS, XU; Distinct Procedural Service
- Modifier 62 Two Surgeons or Cosurgeons
- Modifier 63 Procedure Performed on Infants Less Than 4kg
- Modifier 66 Surgical Team
- Modifier 78 Unplanned Return to the Operating or Procedure Room
- Modifiers 80, 81, 82, AS; Assistant at Surgery - Medicare Advantage
- Modifiers 80, 81, 82, AS; Assistant at Surgery
- Intraoperative Monitoring
- Associated Claims
- Frenotomy
- Discarded Drugs and Biologicals
- Maximum Daily Units
- Hiatal Hernia Repair Gastropexy
- Ambulance Guidelines
- Reimbursement of Medications for Facilities
- Urine Drug Testing
- Blood Processing
- Modifier 50; Bilateral Procedure (Medicare Advantage)
- Reimbursement of Facility Room and Board
- Chronic Care Management Services Medicare Advantage
- Reimbursement of Chest X-Rays and Radiologic Guidance for Facilities
- Reimbursement of Multi-Dose Inhaled Medications
- Reimbursement of Multi-Dose Topical Medications
- Spinal Angiography
- Reimbursement of Intravenous (IV) Solutions, Premixed IV Medications and Total Parenteral Nutrition (TPN) for Facilities
- Reimbursement of Respiratory Therapy Services for Facilities
- Implants and Implant Components
- Modifier 51 and Multiple Procedure Payment Reduction Logic (Medicare Advantage)
- Modifier 52; Reduced Services
- Modifiers 73 and 74; Discontinued Services
- PAP Supplies
- PAP Supplies - Medicare Advantage
- Correct Coding Guidelines
- Facility DRG Validation
- Physician Concierge Services - Medicare Advantage
- DME Purchase and Rental Limitations
- DME Purchase and Rental Limitations - Medicare Advantage
- Virtual Care
- Preventive Medicine Evaluation and Management Visits
- Diabetic Supplies
- Pneumatic Compression Device
- Pneumatic Compression Device Medicare Advantage
- Pricing codes without RVUs - Medicare Advantage
- Reimbursement Methodology for Non-Participating Providers
- Reimbursement Methodology for Non-Participating Providers - Medicare Advantage
- Durable Medical Equipment Purchase and Rental Limitations
- Durable Medical Equipment Purchase and Rental Limitations (Medicare Advantage)
- Urine Drug Testing
- Adoptive Cellular Therapies and Gene Therapies
- Diabetic Supplies
- Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Reimbursement
- Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) Reimbursement - Medicare Advantage
- Modifier 54; Surgical Care Only; Modifier 55; Postoperative Management Only; Modifier 56; Preoperative Management Only – Medicare Advantage
- Dental Policy
- Table of contents
- Whats new dental
- Reimbursement for Dental Anesthesia Procedures
- Occlusal Adjustment
- Bacteriologic Studies Culture
- Oral Pathology Laboratory
- Pulp Vitality Tests
- Endodontic Therapy Root Canal
- Gross Pulpal Debridement
- Pulp Capping Indirect
- Dental Accident
- Laser Treatment for Restorative Procedures
- Multiple Surface Restorations Same Tooth
- Temporomandibular Joint Dysfunction
- Tongue Thrust Therapy
- Biopsy of Oral Tissue
- Cytology Sample Collection
- Frenulectomy
- Oroantral Fistula Closure Primary Closure of a Sinus Perforation
- Removal of Tumors Cysts and Neoplasms
- Surgical Incision
- Repair of Orthodontic Appliance
- Replacement of Lost or Broken Retainer
- Treatment for Teeth Malalignment or Malocclusion
- Autogenous Connective Tissue Graft
- Apically Positioned Flap
- Bone Replacement Graft
- Chemotherapeutic Agents
- Combined Connective Tissue and Double Pedicle Graft
- Distal or Proximal Wedge Procedure
- Free Soft Tissue Graft
- Full Mouth Debridement
- Non-autogenous Connective Tissue Graft
- Pedicle Soft Tissue Graft
- Surgical Revision Procedure per Tooth
- Dental Prophylaxis Adult and Child
- Topical Fluoride Application
- Interim Prosthesis
- Partial Dentures
- Provisional Retainer Crown
- Surgical Placement of Implant Body Endosteal
- Surgical Placement Eposteal Implant
- Buildups
- Direct Resin Restorations
- Provisional Crown
- HbA1c In office Point of Service Testing
- Non-Reimbursable Dental Services
- Reimbursement Policy
- Printed Material
- Pre-authorization
- Products
- Programs
- BlueCard Program
- Cost and quality
- Medical management
- Medicare Quality Incentive
- Medicare Star Ratings
- Pharmacy
- Risk adjustment
- Secure portal
- Terms of use
- Dental
- p13n
- Redirect Audience
- Publishing test
- amzn
- appfeedback
