Bundling Inpatient/Outpatient Services for Reimbursement

Blue Cross and Blue Shield of North Carolina (Blue Cross NC) has developed a reimbursement policy to provide clarification to existing information in The Blue Book Provider E-manual related to routine supplies and services provided in outpatient and inpatient settings. Examples included in the policy do not represent an all-inclusive list. 

This policy is intended to assist providers with frequently asked questions when billing for routine supplies and services. Blue Cross NC will limit reimbursement for routine services, supplies and equipment according to the criteria outlined in this policy.  

These updates are consistent with guidance from the Centers for Medicare & Medicaid Services. These changes apply to the following lines of business: Administrative Services Only (ASO), fully insured membership, Blue Card IPP Host and the State Health Plan (SHP).