Effective June 1, 2023, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) will apply revisions to the Reimbursement Policy "Bundling Guidelines" to include Dialysis Routine Services and Supplies.
The Centers for Medicare and Medicaid Services (CMS) has a list of supplies, labs, and drugs that are bundled into the dialysis payment and are updated annually. These services are included in the per diem payment for dialysis and will not be separately reimbursed.
Similar to CMS, drugs eligible for Transitional Drug Add-on Payment Adjustment (TDAPA) status can be paid separately outside of the dialysis bundle when appended with AX modifier. For more information you can reference the full commercial reimbursement policy and MA reimbursement policy.
This communication applies to State Health Plan (SHP), Federal Employee Program (FEP), Administrative Services Only (ASO), Fully Insured, and Blue Card host claims. It does not apply to Blue Card home claims.
Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities. Learn more about our non-discrimination policy and no-cost services available to you.
Information in other languages: Español 中文 Tiếng Việt 한국어 Français العَرَبِيَّة Hmoob ру́сский Tagalog ગુજરાતી ភាសាខ្មែរ Deutsch हिन्दी ລາວ 日本語
© 2025 Blue Cross and Blue Shield of North Carolina. ®, SM Marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield plans. All other marks and names are property of their respective owners. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association.