Back to dashboard
All PlansAdministrativeHigh impact

Only 30 Days Left - Don't Miss Your Payments!

Blue Cross Blue Shield of Vermont·VT · OB-GYN·Provider News
Effective date
Oct 1, 2026
We identified it
Sep 1, 2026
Days to comply
16 days

Summary

Blue Cross and Blue Shield of Vermont is discontinuing paper check payments effective October 1, 2026. All providers must enroll in Electronic Fund Transfer (EFT) before this date to continue receiving timely payments. Additionally, multiple policy updates take effect on November 1, 2026 (medical policies, provider handbook, preventive guide, and codes), and NDC billing rules will be systematically enforced starting October 30, 2026, potentially resulting in claim denials for non-compliant submissions.

Action Required

Before Oct 1, 2026
REQUIREMENTS: By October 1, 2026: Billing team must enroll in Electronic Fund Transfer (EFT) with Blue Cross VT to ensure uninterrupted payment processing. Sign up immediately via the Blue Cross VT provider portal or contact Provider Relations at (888) 449-0443, option 1. After October 1, 2026, paper checks will no longer be issued. By October 30, 2026: Billing team must audit all claims submitted for services requiring National Drug Code (NDC) billing to ensure compliance with NDC, Unit of Measure, and Quantity requirements. Update billing software to systematically enforce NDC billing rules. Claims processed on or after October 30, 2026 that fail to comply will be denied. By November 1, 2026: Billing and coding team must review and implement updates to medical policies, provider handbook, preventive guide, and code maintenance changes available on the Blue Cross VT website. Update internal documentation and billing system rules accordingly. For obstetric services with dates of service on or after September 1, 2026: Providers must bill prenatal visits using E/M codes appended with modifier -TH (not global codes 59425 or 59426) and must include appropriate ICD-10-CM Z34A category codes with required 4th character to document gestation. Medical record documentation must support medical decision making or time per CPT guidelines. Failure to comply will result in claim denials. Immediately: Ensure third-party billers and vendors have proper authorization with Blue Cross VT and that proof of business associate relationship is available upon request per Provider Handbook Section 6.1. Do not allow AI-generated inquiries or automated calls to contact Blue Cross VT, as these will be disconnected.

Affected Billing Codes

59425
59426
Z34A