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The following materials are specific to our Medicare Advantage line of business. In addition to provider manuals, we’ve included a reference on the CPT Category II coding incentive. 

BlueCross TotalSM PPO – These plans offer a network of preferred providers. Members save money when they use in-network providers. The can also seek care out of network.  

BlueCross SecureSM HMO – These plans offer a network of providers. The plan only reimburses for services from providers within the network. Out of network services are NOT covered (members should refer to their Evidence of Coverage for exceptions).

CPT Category II Coding Incentive for In-Network Providers – Network providers can earn incentives for billing certain CPT Category II codes as part of the Healthcare Effectiveness Data and Information Set (HEDIS) clinical measures. 

 

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