BCBSWY is updating its DME reimbursement rates. Effective June 1, 2025, our DME reimbursement will be based on Medicare’s DMEPOS 2024 non-rural schedule.
- Reimbursement for respiratory equipment will be set at 140% of the fee schedule.
- Reimbursement for non-respiratory equipment will be set at 100% of the fee schedule.
Understanding Labs Webinar Save the Date
Mark your calendars for our upcoming webinar Understanding Labs
12 p.m. – 1 p.m. MST, Wed., April 23, 2025
- Learn about laboratory benefits including cost share, medically unlikely edits, and frequency limitations.
- We’ll cover how to bill, what modifiers affect payment, and where to bill a claim for labs utilizing the BlueCard System.
- Understand how CLIA Certificate of Waiver effects reimbursement and coding requirements.
- How BCBSWY is educating members, so they understand that not all labs are preventive.
Details on how to register to come.
Provider Directory Validation Reminder
You can find the Provider Directory Validation 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 tax ID combinations.
No Surprises Act (NSA) requires you confirm this information every 90 days.
