WyoBlue Advantage: A New Option for Your Medicare Patients

Launched October 1, WyoBlue Advantage is a locally based Medicare Advantage plan that offers added benefits to help patients stay engaged in their care—ranging from supplemental services to enhanced support programs.

Backed by a Wyoming-based team and the trusted Blue Cross Blue Shield of Wyoming network, WyoBlue Advantage is built to strengthen provider-patient relationships across the state.

Learn more about how WyoBlue Advantage can support your practice and your patients at WyoBlueAdvantage.com.


New CMS Billing Update for COVID-19 Vaccine Administration

Effective October 1, 2025, the Centers for Medicare & Medicaid Services (CMS) has implemented an update to the National Correct Coding Initiative (NCCI) Procedure-to-Procedure (PTP) edits that directly impacts billing for COVID-19 vaccine administration.

What’s Changing?

  • CPT Code 90480 (COVID-19 vaccine administration) now requires Modifier 59 when reported with certain services that are subject to NCCI bundling edits.
  • Modifier 59 must be appended only when the vaccine administration is distinct and separately identifiable from other services rendered on the same date.

Gold Carding Program Launches Soon to Streamline Prior Authorization

Beginning January 1, 2026, we’re introducing the Gold Carding Program—a new initiative that simplifies the prior authorization process for providers with consistently high approval rates.

This program supports our shared goal of timely access to care and aligns with state legislation focused on reducing administrative burden and enhancing provider-payer collaboration.

Eligibility Highlights:

  • Submit ≥5 prior authorization requests for a CPT/HCPC code within 12 months
  • Maintain ≥90% approval rate for those requests

Gold Carding Benefits:

  • Less paperwork
  • Quicker access to care
  • Greater provider satisfaction
  • Continued emphasis on quality, evidence-based treatment

Next Steps:

Eligible providers will receive formal notification and instructions for submitting advance notifications in place of full prior authorization documentation. Gold Card status will be reviewed periodically for compliance.

For questions, contact our Provider Relations team at

1-888-666-5188 or [email protected].

Thank you for your dedication to Wyoming’s health care community.


BCBSWY Radiology Services Reimbursement Update

Effective February 1, 2026, BCBSWY will implement reimbursement changes for radiology services. These updates are expected to have a neutral impact on radiation oncology services across all fee schedules, as well as on non-MRI services under the Wyoming Choice fee schedule.

BCBSWY anticipates a 5% overall reduction in reimbursement for all other radiology services not covered above, across all fee schedules.
 

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