Feb. 11, 2025
On June 1, 2025, we’ll update the Schedule of Maximum Allowances, including durable medical equipment supplies, prosthetics, orthotics and clinical laboratory codes. This update affects PPO and Blue Choice PPOSM fee schedules for professional providers.
The update takes into consideration revisions made by the Centers for Medicare & Medicaid Services to the resource-based relative value scale. Reimbursement for services provided on or after June 1 will be based on the updated fee schedule. You may request fee schedules for the update starting May 28, 2025.
For more details: This information isn’t intended to be an exhaustive listing of all changes. For more information on the changes, use the Fee Schedule Request Form on our Forms page and specifically request the update featured in Blue Review. You may request annual and quarterly fee schedule updates using this form.
Electronic requests: Professional providers participating in our PPO and Blue Choice PPO networks may use the Fee Schedule Listing tool on Availity® Essentials to submit electronic requests and receive the contracted price allowance for specific codes.
We’ll continue to notify you of any significant changes to the physician fee schedules in Blue Review.
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