In a notice sent to physicians on September 23, Blue Shield notified physicians about a change in the physician fee schedule. The new fees took effect December 1, 2013.  The insurer said that it would be increasing payment for evaluation and management services for preventive care. Additionally, Blue Shield notes payment increases for the more commonly billed office visit codes 99204, 99205, 99213 and 99214. The new rates are available on the Blue Shield website:

  • Go to “Helpful Resources,”
  • Click “Professional Fee Schedule”
  • Then click “Search the Claims Fee Schedule”.

Note: Though not indicated in the letter or on the website, in order to access the new fees, practices must change the default date of service on the “Search Fee Schedule” page to December 1, 2013, (effective date of the change) or later. Failure to do so will result in information on the current fee schedule rather than the new fee schedule. Physicians can also request a copy of the new fees by completing the allowance review form enclosed with the notice, or by calling the Blue Shield Provider Services Department at (800) 258-3091. Physicians are encouraged to carefully review all proposed amendments to their health plan or medical group/IPA contracts. If you need help analyzing the financial impact of these changes to your practice, we can help calculate the net impact of these changes on your practice. Additionally, if you need help analyzing your insurance contracts we can help too.

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