ORIGINALLY PUBLISHED JULY 30, 2021 FOR PROFESSIONAL PROVIDERS ONLY UPDATED FEBRUARY 16, 2022 HIGHMARK COMMERCIAL STANDARD PROFESSIONAL FEE SCHEDULE & PRICING METHODOLOGY UPDATE Effective October 1, 2021, Highmark will be making an annual update to our standard professional fee 1 schedule and pricing methodology in all of Highmark’s service areas (Pennsylvania, Delaware, and West Virginia) for the commercial lines of business. This change does not affect Highmark’s Medicare, Medicaid, or any value-based fee schedule adjustments. The updates made to the commercial standard professional fee schedule and pricing methodology is a continued effort to align with industry-standard values ...
Professional Fee Schedule User Guide via the Availity® Provider Portal Aug. 2021 The AvailityFee Schedule tool allows professional providers participating with Blue Cross and Blue Shield of Illinois (BCBSIL) to electronically request a range of up to 20 procedure codes and immediately receive the contracted price allowance for the patient services you perform. Fee Schedules are accessible to existing Availity Administrators and users assigned the Fee Schedule role in Availity. If you are not yet registered, sign up today at Availity , at no cost. Information in this user guide is not applicable to Medicare Advantage and Illinois Medicaid. Their fee ...
2021 Kentucky Medicaid ASC Fee Schedule Attached is the list of procedure codes that are covered for provider type 36. If the procedure code has an ASC Payment Group the group is listed with the effective date and the allowed amount for the group. A reminder, the dental procedure codes have an ASC Payment Group listed, but the reimbursement rule is not set up to use the ASC Payment grou The reimbursement rule is set up to look for a ASD rate (a provider percent rate found on the provider panel. If the provider does not have a ASD percent ...
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