Effective December 1, 2025, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is updating its Bundling Guidelines reimbursement policy.
Services performed by physicians and mid-level providers (i.e., nurse practitioners, certified nurse midwives, clinical nurse specialists, certified registered nurse anesthetists, and physician’s assistants) that are eligible to submit claims must be credentialed with Blue Cross NC, and are not eligible for incident-to billing. Please see the related policy notification for more information. Additionally, please see the list of providers required to be credentialed / recredentialed with Blue Cross NC.
Blue Cross NC is implementing this change to ensure consistent reimbursement practices. Eligible mid-level providers must be credentialed and bill under their own NPI. This aligns with Blue Cross NC’s mission to make healthcare more affordable for all.
This policy will apply to Commercial, Inter-Plan Program (IPP) Host, and Federal Employee Program (FEP). This will not apply to IPP Home or Medicare Advantage.