CommercialReimbursementMedium impact
Procedure Code and Fee Schedule Updates
BCBS Illinois·IL · Orthopedics·General
Effective date
Jun 1, 2026
We identified it
Jun 16, 2026
Summary
Blue Cross Blue Shield Illinois will launch their annual Schedule of Maximum Allowances update on June 1, 2026, affecting reimbursement rates for durable medical equipment, prosthetics, orthotics, and clinical laboratory services. The update is based on CMS revisions to the resource-based relative value scale and affects PPO and Blue Choice PPO fee schedules for professional providers.
Action Required
By May 26, 2026: Billing team must request updated fee schedules using the Fee Schedule Request Form or the Fee Schedule Listing tool on Availity Essentials. Review new reimbursement rates for DME, prosthetics, orthotics, and lab services. Update billing system with new allowable amounts effective June 1, 2026 to ensure accurate reimbursement expectations.