Reimbursement Changes/Updates

Facility Relative Values

Non-Facility Relative Values

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.

Independent Clinical Lab Schedule

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

DME Schedule

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

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

Other Codes Schedule

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