Return to Provider News

New Clinical Editing Policy Effective April 1, 2022

Audience: All Professional Providers

Excellus BlueCross BlueShield is implementing a clinical editing policy effective April 1, 2022, which will no longer provide reimbursement for codes that have a Centers for Medicare and Medicaid Services (CMS) status indicator. The policy, which is in line with CMS rules, only applies to Medicare Advantage business. 

The Health Plan uses the Medicare Physician Fee Schedule to apply the status indicator rules, per CMS guidelines. Access the fee schedule at

Thank you for the service that you provide to our valued members. If you have questions, please contact your Provider Relations representative.

Related News
Performant Outpatient Complex Chart Audit Program Update

Updated NDC/HCPCS Codes When Billing for Depo-Provera® (Medroxyprogesterone)

Clinical Editing Reminder: Multiple Procedure Payment Reduction Rules

Independence Day Office Closure and Pay Cycle Update

HIV-Experienced Practitioner Identification



Updates and Reminders

IE Browser Modal