ABCBS to Revise Metallic Plan Reimbursement

After several weeks of ongoing talks with state legislators, Arkansas Blue Cross and Blue Shield has decided to revise its highly controversial decision to reduce payments to specialists by 15% for patients covered by individual metallic (plans created by the ACA) policies.  Instead, effective July 1^st, the state’s largest carrier will amend its contracts to effect what amounts to a 10% reduction to all physicians.  According to a spokesperson for the carrier,  primary care and specialists will be paid 90% of the True Blue fee schedule for E&M codes and 80% for procedure-based codes.  Most procedure-based codes are already paid at 90%, therefore a 10% decrease will lower that to 80%.