Blue Cross Blue Shield NC Update: Fee Schedule Changes and Your Contract

Email to NASW-NC from BCBSNC on April 19, 2023:

While many of the professional fee schedules at Blue Cross NC update each year on April 1 based on a percentage of CMS rates, we routinely collaborate with providers to account for special circumstances to identify any opportunities to best support providers in our network. For your reference, since 2009, our pricing policies have applied reimbursement percentages established through provider contracts with rates published by the Centers for Medicare & Medicaid Services (CMS), and therefore updated fee schedules may reflect increases or decreases in provider reimbursement rates based on CMS changes.

I am pleased to let you know that we will be updating contracts for independent behavioral health providers to increase the percentage of Medicare applicable to reimbursement rates for the important services they provide.  We are targeting next week for communications to Providers on this increase.   We are hoping your association can make your stakeholders aware to be on the lookout for this important communication.

Please know that Blue Cross NC is committed to a whole-person approach to care, and we understand that good health depends on good mental health.  Thank you for your help in communicating this important upcoming change for independent behavioral health providers.

Email to NASW-NC members on May 3, 2023:

Thank you to those of you all who let us know your saw a decrease in your reimbursement rates from Blue Cross Blue Shield North Carolina.

We spoke with BCBS this morning and they informed us that a letter was mailed to providers on Monday, May 1, 2023 letting providers who signed contracts after 2008 know that they increased your % of Medicare reimbursement rate due to CMS decreasing reimbursement rates that were increased due to COVID. They said, “No one should see a decrease.”

They anticipated this decrease but didn’t get the adjustments rolled out in time and you should see your current rates in Blue E and that the April decrease will be added back in retroactively in the next few months. If you are seeing a reimbursement decrease in Blue E, please let me know.

If you have a contract with BCBS prior to 2008 that has not been updated, please contact Valerie Arendt at director.naswnc@socialworkers.org.

If you are receiving this email and you are not a member of NASW, we are the only entity working with insurance companies on behalf of clinical social workers in North Carolina. Please join us, we do not exist without our robust and active membership: https://www.naswnc.org/?page=304

Thank you to the members of NASW-NC. We are here to continue to support you throughout your entire social work career.