Update: New reimbursement policy: Nucleic acid testing

April 3, 2026, Update: Blue Cross and Blue Shield of North Carolina (Blue Cross NC) posted a communication on February 2, 2026, regarding the reimbursement policy for nucleic acid testing.

Blue Cross NC is committed to working with providers as we implement new policies. Due to provider feedback, we have postponed the effective date of this policy. Please continue to monitor future communications for updates on this policy. This update applies to Commercial, Inter-Plan Program (IPP) Host, Medicare Advantage, and Federal Employee Program (FEP). This does not apply to IPP Home.

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Blue Cross and Blue Shield of North Carolina (Blue Cross NC) reimburses codes for multiple individual labs using the most comprehensive procedure code.

Effective April 3, 2026, when two or more nucleic acid tests are billed by the same group practice for the same member on the same date of service, a multiple procedure payment reduction will apply. This reduction applies to both multiple units of the same service and multiple individual services. Reimbursement will be 100% for the first unit/initial lab and 50% for each additional unit and/or lab performed on the same day.

See the related Commercial policy notification and Medicare policy notification for more information.  This policy applies to Commercial, Inter-Plan Program (IPP) Host, Medicare Advantage, and Federal Employee Program (FEP). This does not apply to IPP Home.