Effective September 1, 2026, BCBSWY will continue implementing updated reimbursement rates for all physician‑provided surgical services. These changes are intended to further align surgical reimbursement with the Resource-Based Relative Value Scale (RBRVS) payment methodology.
Aligning rates with RBRVS allows BCBSWY to more effectively maintain fee schedules over time and provides greater consistency in how both existing and emerging surgical services are reimbursed. As a result of this alignment, reimbursement for individual procedure codes may increase or decrease based on their current relationship to RBRVS values.
Because this update is applied at the code level, the financial impact will vary by provider and specialty. While some providers may experience increases and others decreases for specific services, the change is designed to be net neutral overall from a BCBSWY reimbursement perspective.
Provider Practice Change Reminder
To help ensure accurate records and timely updates, providers are asked to notify BCBSWY Provider Relations when a physician or other provider leaves a practice.
Keeping Provider Relations informed of these changes supports consistency across our systems and helps prevent issues related to claims processing, directory accuracy, credentialing records, and member access to care.
As a best practice, please notify Provider Relations as soon as possible when a provider:
- Separates from a practice
- Changes practice locations
- Retires or stops seeing patients
- Transitions to a new group or enrollment status
This communication helps ensure smooth transitions for providers, practices, and members. If you have questions or need assistance reporting a change, contact Provider Relations directly at 1-888-666-5188 or [email protected].
Thank you for your continued partnership.
Site of Care Program Updates
Beginning in July 2026, the following medications will be added to the Site of Care program:
New medications include:
- Evkeeza
- Aralast NP
- Glassia
- Prolastin‑C
- Zemaira
For additional details, including policy information, please visit our Medical Policy page by clicking here. A complete list of medications included in the Site of Care program can be found by clicking here.