Updated Rates for Health Care Professionals 

Effective July 1, 2025, Blue Cross Blue Shield of Wyoming (BCBSWY) will implement new rates for all surgery services, provided by physicians, to align with the Resource-Based Relative Value Scale (RBRVS) payment system. At this time, our Ambulatory Service Center (ASC) rates will remain the same. The change will allow us to better maintain our rates over time and to provide more consistency in how emerging services are reimbursed.

These new relative values will result in a more consistent relationship between rates for related services.

BCBSWY will be establishing a clear differential in our surgical rates to favor lower cost settings. To support that, BCBSWY will be implementing a site of service differential on all codes where it is supported by RBRVS to encourage in-office surgery where possible. Additionally, BCBSWY will be implementing a differential to benefit surgeons who perform services in ambulatory surgical centers.

Rates for individual codes may increase or decrease, depending on the rate’s current relationship to RBRVS. Due to the changes in individual codes, results may vary, and some providers may see a net increase or decrease for these surgery services.

For questions regarding these changes please contact Provider Relations at 1-888-666-5188 or email [email protected].

Register NOW! Understanding Labs Webinar

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.