DME Reimbursement Update


Holiday Closures

BCBSWY is updating its DME reimbursement rates. Effective August 1, 2023, our DME reimbursement will be based on Medicare’s DMEPOS 2023 non-rural schedule.

  • Reimbursement for respiratory equipment will be set at 108% of the fee schedule.
  • Reimbursement for non-respiratory equipment will be set at 100% of
    the fee schedule.

Memorial Day Closure

In observance of Memorial Day, our offices will be closed Monday, May 29, 2023.

Coding Advice – Excludes 1 Note

BCBSWY reviews claims for Excludes 1 Note instructions per the ICD -10- CM Official Guidelines for Coding and Reporting.

An Excludes 1 Note indicates that two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition. Billed services with one or more diagnosis code pairs that are subject to an Excludes 1 Note will be denied.

Itilliti Webinar

Please join BCBSWY for a webinar with Itiliti and ACAP on June 1, 2023 at noon. You do not need to be an ACAP member to register. All BCBSWY providers are encouraged to attend.

BCBSWY and ACAP will discuss how BCBSWY has reduced the burden of prior authorizations within the company and for providers. Please register using the button below.

Register Here

Directory Provider Directory Tool Reminder

Reminder: You can now find the Availity Directory Validation Training 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.

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

Visit Now


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