value code billing for bcbs

AmyB 2 years ago in Billing/Electronic Modules updated by sadie twite 2 years ago 3

Has any SUD providers figured out how to bill with the Value code for Blue plus claims since they want us to stop using the HCPC code/combination effective 5.1.22. They say they do not want to see any HCPC for the TX line they want a value code to be billed. Only 1 value code can be billed on a claim and I am billing with that for the room and board part of the claim. I have asked my Provider contact person with no help.

Also since i turned on the Value code option on my payers BCBS pmap and UCARE the claims deny for use of said Value code. Procentive wont let it out the door. What a mess....

Hey Amy,

We actually have a group of providers meeting tomorrow regarding this issue at 9 AM If you would like to join.

I think we figured a way to get it through to bcbs -  and the state changed their language around requiring us to bill for RB for denial  from MCO then to bill them at the state. So we removed the room and board line, and I was also advised to not have the step down in the same claim due to them not accepting two value codes on one claim at BCBS.

Ucare has YET to give me an sort of answer as to how to get our claims paid. 

I agree it's a mess. Changes like this should but much more thought through, informed to all privders through email and letter and tested with any EHR using their clearing houses prior to the changes. 

Feel free toto email me if you would like to join the zoom.


We are doing the same thing, make sure the value code is flowing on your claims and only send the treatment code. Do not send the room & board any longer to Blue Plus.

We have not heard anything similar from Ucare but have been having issues with our claims being denied for addresses. They don't want the billing address to be on the claim, only the service facility address. We have figured this out by changing the settings in the location module so all locations have their same address as the billing location. You can find this when you open a location, go to the billing tab, and then drop down the menu under billing location. 

Then go to each of your payers that are not Ucare and choose the billing location as your current billing location. Do not change the ucare payer so it will only send the service location. 

Hopefully that makes sense. Feel free to email me if you want screenshots. sadie.twite@mntc.org.

Hi Jenna i will email you. Thank you