October 20, 2021
We invite providers that participate in Blue Cross and Blue Shield of New Mexico’s (BCBSNM’s) Blue Cross Community Centennial network to take part in our temporary provider incentive program for outpatient visits documenting weight assessment and counseling for nutrition and physical activity for children and adolescents (Service). You may receive an increase in reimbursement of $50 for these visits with some of our Blue Cross Community Centennial members.
How to submit a claim for an eligible visit
Any outpatient encounter with a primary care provider may be eligible for this incentive. To qualify for the increase in reimbursement, providers must:
- furnish and document the service between July 1, 2021 and December 31, 2021, and
- submit a CMS-1500 clean claim with HCPCS code G0447, or
- submit a UB-04 clean claim with code G0447 for outpatient encounters, if the provider is an FQHC.
The incentive will be automatically applied to claims that meet the program criteria. Any reimbursement will be made according to Blue Cross and Blue Shield of New Mexico (BCBSNM) medical and reimbursement policies.
BCBSNM may extend, discontinue or change this program at any time. We will publish notice if we do.
By submitting procedure code G0447 on the claim, your organization is representing to BCBSNM that the terms and conditions of this letter for use of the code are agreeable and have been met. Your organization is also consenting to possible selection for a random audit to confirm the members for whom claims with the procedure code and modifier were eligible, along with general medical record quality elements to include, without cost to BCBSNM for any copies, signed consent, biographical data, documented diagnosis, service dates, medication information, treatment plan, and confidentiality safeguards.
For questions regarding this communication, please contact Quality Improvement at qualityinquiry_SG_Full@bcbsnm.com