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Medicare Advantage durable medical equipment pricing update effective September 1, 2026 July 01, 2026 Blue Medicare Physicians & Specialists Facilities & Hospitals

Blue Cross and Blue Shield of North Carolina (Blue Cross NC) would like to inform providers of an upcoming revision to our Medicare Advantage Pricing Policy and the Provider Blue Medicare Supplemental guide (PDF). 

Effective September 1, 2026, Blue Cross NC will begin applying rural and non-rural area pricing to all durable medical equipment (DME) claims.

This update is intended to align pricing more closely with Centers for Medicare & Medicaid Services (CMS) and applicable geographic pricing methodologies for DME services and applies to Medicare Advantage plans only. Providers should review their billing and operational processes to ensure readiness for claims with dates of service on or after September 1, 2026.

For questions or additional information, contact the Network Management line at 800-777-1643.
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