Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is committed to supporting providers, especially during the public health emergency, when access to care is critical.
Blue Cross NC previously communicated that effective July 1, 2021, there would be updates to the Status "B" and Status "T" codes found in the National Physician Fee Schedule (NPFS) by the Centers for Medicare and Medicaid Services (CMS) that would impact reimbursement.
Due to recent concerns regarding the bundling of Status “B” codes 99050 (after hours services when office is normally closed) and 99051 (services provided in the office during regularly scheduled evening, weekend, or holiday officer hours) as described in the Status Codes Reimbursement Policy, Blue Cross NC has made the business decision to update the Status Codes Reimbursement Policy, effective January 21, 2022.
Blue Cross NC will provide reimbursement for service code 99050 and 99051 for any place of service other than urgent care or emergency department for all specialties.
Claims with dates of service prior to January 21, 2022, that are already pended for post pay review will be processed according to the policy in place on the date services were rendered.
Please note: It is possible that you will receive a recoupment notice even though our policy has been updated. Our system is still processing claims that are pended for post pay review (7/1/21 to 1/20/22 dates of service).
These changes apply to the following lines of business: Administrative Services Only (ASO groups), Federal Employee Program (FEP), fully insured membership, Blue Card IPP Host, and the State Health Plan (SHP).
If you have questions, please call our Provider Blue LineSM at 1-800-214-4844 for assistance.