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BCBS Vaccine Reimbursement Update

Medical Billing


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According to a recent alert issued by Blue Cross Blue Shield, value-based reimbursement will be applied to the new codes for COVID-19 vaccine administration. This change is effective July 1, 2021 and applies to primary care providers (PCPs) and specialists receiving value-based reimbursement. Currently, value-based reimbursement for PCPs is applied to select E&M, preventative health, telehealth, and care management codes. The procedure codes that will now receive value-based reimbursement under this change are:

  • *0001A
  • *0021A
  • *0002A
  • *0022A
  • *0011A
  • *0031A
  • *0012A
 

Additionally, value-based reimbursement for PCPs will be applied to six other vaccine administration codes, effective July 1, 2021. These codes are:

  • *90460
  • *90472
  • *90461
  • *90473
  • *90471
  • *90474

Works Cited
“We’re Applying Value‑Based Reimbursement to Procedure Codes for COVID‑19 Vaccine, Other Immunizations.” The Record, Blue Cross Blue Shield of Michigan, May 2021, www.bcbsm.com/content/dam/microsites/corpcomm/provider/the_record/2021/may/Record_0521i.shtml.

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