Ambulance Rate Increases and CPT Code 83036 Billing Tips

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Holiday Closures

Welcome to 2024!

Please note we will be closed Monday, Jan. 15 in observance of EqualityDay. We will resume business Tuesday, Jan. 16, during our regular hours.


Ambulance Rate Increases

Effective 2/1/2024 we are updating our rates for ambulance services.

  • Ground ambulance services will have a 2.6% increase.
  • In-network air ambulance services will have a 3% increase for transport codes and a 4% increase for mileage codes. Out-of-network air ambulance reimbursement will remain as is.

CPT Code 83036 Billing Tips

As a reminder, Providers should include category II codes when billing CPT code 83036. Claims without the category II codes billed using CPT code 83036 will be denied. They will need to be resubmitted as a corrected claim.

Please use the codes below now to ensure proper categorization.

CPT 83036 for an HbA1c laboratory test will need the appropriate Category II code on the same claim.

CAT II codes are an informational code and should be billed with either a $0.00 charge or a $0.01 charge if required by your system or clearinghouse.

CAT II codes are for diagnostic/screening processes or results.

Category II Codes for HgbA1c

Code Usage
3044F-HbA1c  —– Less than 7.0%
3051F-HbA1c —– Greater than or equal to 7.0% and less than 8.0%
3052F-HbA1c —– Greater than or equal to 8.0% and less than 9.0%
3046F-HbA1c  —– Greater than 9.0%

Claim Adjustment Form

 


Good Habits

Provider Directory Validation Tool Reminder

You can find the Provider Directory Validation Tool guide under the Provider Resources section on the right rail of the website.

Providers can use the Directory Validation tool on the Availity Portal to find NPI and ID combinations.

The No Surprises Act (NSA) requires you to confirm this information every 90 days.

Confirm Today!


Availity Is The Place for Authorization Submissions

As a reminder, authorizations should be submitted through Availity.

BCBSWY will no longer accept voicemail, mail, or faxed submissions for authorization requests except for the following items:

  • Any FEP authorization not accepted in Availity.
  • Any authorization triggering an error in Availity that has been reported to Provider Relations by calling 1-888-666-5188.
  • Any authorization for transplant services.
  • Any authorization for our pharmacy team.

All authorizations must be submitted through Availity.

Visit Availity!

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