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2025 Federal Employee Program (FEP) Provider Quality Incentive Program
Act
by Jan 31, 2026
Effective date
Jun 1, 2025
Identified
Oct 3, 2026
Summary
FEP Blue Cross Blue Shield has launched a new Provider Quality Incentive Program for 2025 that pays practices $20-$35 per closed care gap for preventive and chronic disease services delivered June 1 - December 31, 2025. Billing teams must submit claims with correct CPT II codes by January 31, 2026, or use alternative supplemental data submission methods by specified deadlines to earn incentive payments distributed in Q1 and Q3 2026.
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What to do
by Jan 31, 2026 · 5 steps
01Billing team must ensure all FEP quality measure claims are submitted with correct CPT II codes for the following measures: Breast Cancer Screening (BCS-E), Colorectal Cancer Screening (COL-E), Cervical Cancer Screening (CCS-E), Glycemic Status Assessment/A1c <8% (GSD), and Statin Therapy/Statin Adherence 80% (SPC).
02Clinical staff should begin reviewing HorizonDocs Patient Data FEP Quality Management Reports monthly to identify gap list patients and schedule appointments before December 31, 2025.
03For practices using supplemental data submission: Standard ECDS submissions due by February 28, 2026 via HorizonDocs Secure File Transfer; Non-standard supplemental data due by November 15, 2025.
04Failure to submit compliant claims or supplemental data by deadlines will result in loss of incentive payments ($20-$35 per gap closed).
05Designate billing team member to track submission deadlines and coordinate with clinical staff on gap closure documentation.
Original notice
2025 Federal Employee Program (FEP) Provider Quality Incentive Program
horizonblue.com · Always check the source before changing claims.