Saturday, December 16, 2017
News/Events News Alerts

Blue Shield to update fee schedule effective December 1

Blue Shield recently announced changes to its physician fee schedule that will take effect December 1, 2016. 

The new rates are now available on the Blue Shield website (under "Helpful Resources," click “Professional Fee Schedule” then click “Search the Claims Fee Schedule”). To view the new fees, change the default date of service on the “Search Fee Schedule” page to December 1, 2016, (effective date of the change) or later.

Physicians can also request a copy of the new fees for up to 20 codes by completing the allowance review form enclosed with the notice, or by calling the Blue Shield Provider Information and Enrollment Department at (800) 258-3091. Blue Shield will provide a response to your inquiry within 10 business days.

As always, physicians are encouraged to carefully review all proposed amendments to health plan or medical group/IPA contracts. The California Medical Association (CMA) reminds physicians that they do not have to accept substandard contracts that are not beneficial to their practice.

To help physicians understand their rights when a health plan has sent notice of a material change to a contract, CMA has published "Contract Amendments: An Action Guide for Physicians," available in CMA's online resource library. The guide includes a discussion of options available to physicians when presented with a material contract change, as well as a financial impact worksheet that will help physicians calculate the net impact of fee schedule changes on their practice. 

Copyright 2017 by Santa Clara County Medical Association