Imaging/Radiation Therapy Ctrs - Reimb. Schedules Effective 7/1/08

Reimbursement Changes and Updates 

Reimbursement Changes/Updates 

 

BCBSTX Relative Values 

Facility Relative Values 

Non-Facility Relative Values 

Clinical Laboratory 

Professional component for procedures listed on the Clinical Lab Schedule will be reimbursed at $5.00 for HMO and $5.50 for PPO.

Codes not listed may require individual consideration (IC) to determine the BCBSTX compensation allowable amount.

Clinical Lab Schedule 

Durable Medical Equipment/Prosthetics and Orthotics 

Codes not listed may require individual consideration (IC) to determine the BCBSTX compensation allowable amount.

DME Schedule 

Drugs

Note: The Drug/Injectable Fee Schedule will be updated on the following dates: 6/1/2008, 9/1/2008, 12/1/2008, 3/1/2009 and 6/1/2009.

Codes not listed may require individual consideration (IC) to determine the BCBSTX compensation allowable amount.

Drug Schedule 

Other Codes 

Codes not listed may require individual consideration (IC) to determine the BCBSTX compensation allowable amount.

Other Codes Schedule 

Multiple Imaging Procedure Reduction – Technical Component  

Multiple Procedure Reduction of the Technical Component (TC) of Certain Diagnostic Imaging Procedures