Blue Cross New Value-Based Payment Program Qualifying Deadline Nov. 30

Blue Cross Blue Shield (BCBS) of Alabama recently sent a notice to providers regarding their new Value-Based Payment (VBP) Program.  Physicians who qualify and perform at or above performance measures will be eligible to earn 5% above the base PMD fee schedule for certain E&M and preventive care services beginning January 2011.

To qualify, providers must meet certain criteria by November 30.  This includes eligible initial specialties of Family Practice, Internal Medicine, General Medicine, Geriatrics and Pediatrics.  In addition, providers must meet the following:

• PMD network participant (at least one year)
• File BCBS claims electronically
• Receive payments via electronic funds transfer.
• Provide 24/7 Coverage
• Sign/return agreement (to be mailed mid-November)

 Note the initial codes and services that may be eligible for the 5% supplemental payment are: 

• E&M – 99201-99205 & 99211-99215
• Preventive – 99381-99387,99391-99397 & G0402

Providers can view performance related criteria at www.bcbsal.com login to Provider Access.  BCBS will post a scorecard December 17.  Prior to this, providers may review their performance related indicators after login to BCBS Provider Access.  More information is available at:  https://www.bcbsal.org/providers/valueBasedInitiatives.cfm