Effective May 1, 2021: Annual fee schedule updates
Effective May 1, 2021: Annual fee schedule updates

Effective May 1, 2021: Annual fee schedule updates

As referenced in our February newsletter, this year’s annual review was delayed because of the CMS fee schedule modifications made in late December in response to the Consolidated Appropriations Act, 2021. As always, our yearly update, effective May 1 this year, is considerably larger in scope than our quarterly updates and affects a substantial number of codes.

Preview the annual fee changes beginning April 1

Our primary annual fee update will be effective May 1, 2021. You can preview the updates on the secure provider portal starting April 1, 2021.

Blue Cross® Blue Shield® of Arizona (BCBSAZ) fee schedules are based on a number of pricing sources that can influence the need for changes. These include Medicare fee schedules, information derived from claims, competitive pricing data, and feedback from BCBSAZ network providers. Our fee updates reflect generally applicable market changes, such as CMS code changes, pricing for newly available drugs, fluctuations in prices for listed drugs, other market shifts, correction of over- or undervalued fees, and modifications based on ongoing utilization analysis.

For your convenience, we have formatted the fee updates spreadsheets to include a sort filter on each column and an added column displaying the percentage of change in the total fee.

To access the updates, log in to azblue.com/providers and go to “Provider Resources > Guidelines > Claim Pricing.” Select one of the “Fee Updates” links: ASC, Outpatient, Professional, Unclassified Drug, or Per Diem Base Rates.

If you have questions regarding fee schedules, contact your provider liaison or call Provider Partnerships at 602-864-4231 or 1-800-232-2345, ext. 4231.

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