Medicare AdvantageReimbursementMedium impact
MAPAP227 - Allowances - Clinical Lab MA allowances added
Blue Cross of Idaho·ID · Pathology·Medical Policy
Effective date
Jan 1, 2025
We identified it
Jun 19, 2026
Summary
Blue Cross of Idaho updated their Medicare Advantage allowances policy to add Clinical Laboratory services. Effective January 1, 2025, pathology services will be reimbursed using Relative Value Unit (RVU) based on Idaho rates rather than previous Medicare fee schedules.
Action Required
By January 1, 2025: Billing team must verify that pathology service claims for Blue Cross of Idaho Medicare Advantage members are processed correctly under the new RVU-based Idaho rate structure. Monitor reimbursement rates for pathology services and compare to previous payments to identify any discrepancies. Contact Blue Cross of Idaho if payment amounts differ significantly from expectations.