BCBSAL Update

Recently, BCBSAL provided policy stating: “Blue Cross requires claims to be billed under the name and National Provider Identifier (NPI) of the provider who actually rendered the service and does not recognize “incident to” billing. Under no circumstances should services performed solely by a CRNP, CNM, PA or PA/SA be billed under a physician’s name and NPI.”

This created confusion among some audiologists in our State who work for physicians as their services are often billed “incident to” under the BCBSAL provider number of the physician.

ALAA sought clarification on appropriate BCBSAL billing policies for audiology services and received the following guidance:

Audiologists Who Work for PhysiciansPatient with BCBS with audiology benefit — bill with audiologist provider number OR bill under supervising physician provider number using “incident to” billing Patient with BCBS without audiology benefit — bill with supervising physician provider number using “incident to” billing Patient with Blue Advantage (Medicare replacement plan) — bill with audiologist provider number only because CMS does not allow “incident to” billing for audiology services.
Audiologists Who do Not Work for PhysiciansPatient with BCBS with audiology benefit — bill with audiologist provider number  Patient with BCBS without audiology benefit — patient must pay for services out of pocket

Patient with Blue Advantage — bill with audiologist provider number only because CMS does not allow “incident to” billing for audiology services. ALAA encourages all audiologists in the State of Alabama to contact their local network services provider to encourage BCBSAL to develop a Preferred Provider Network for Audiologists as they have for Speech Language Pathologists. If you are unsure who your local network services is, check the website here: https://www.bcbsal.org/providers/contacts/index.cfm