Multiple Endoscopy and Therapy Reductions

Effective July 10^th, 2024, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) will begin applying multiple endoscopy and therapy reductions consistent with Centers for Medicare and Medicaid (CMS). The new policy was posted here on May 1, 2024.

When multiple endoscopy or therapy services are performed by the same group practice on the same date of service, reimbursement will be reduced consistent with our policy instructions.

• Multiple endoscopy reductions will be limited to professional claims/services.
• Multiple therapy reductions will be limited to facility claims/services.

This change will apply to Commercial, Host, State Health Plan and Federal Employee Program (FEP). This will not apply to Inter-Plan Program (IPP) Home. This policy currently applies to Medicare Advantage and Experience Health.