Reimbursement Policy Update: Status N Implant Codes Included in Outpatient Service Reimbursement

Beginning January 1, 2027, Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is updating its reimbursement guidelines for certain implant services.

Implant codes included on the Centers for Medicare & Medicaid Services (CMS) Outpatient Prospective Payment System (OPPS) Status N indicator list will not be eligible for separate reimbursement. Reimbursement for these items will be included in the payment for the related outpatient service.

These items are considered routine components of the outpatient service and are reimbursed as part of the overall procedure.

For additional details, review the related Commercial reimbursement policy notification.

Applicability

This policy applies to Commercial, Inter-Plan Program (IPP) Host, Medicare Advantage and Federal Employee Program (FEP). It does not apply to IPP Home.