CommercialReimbursementMedium impact
PAP257 - Multiple Procedures - Removed dates and added multiple unit billing guidelines
Blue Cross of Idaho·ID·Reimbursement
We identified it
Jun 19, 2026
Summary
Blue Cross of Idaho updated their multiple procedure billing policy to remove specific dates and add new multiple unit billing guidelines. The policy clarifies how surgical procedures (CPT codes 10000-69999) are reimbursed when multiple procedures are performed on the same day, with primary procedures paid at 100% and secondary procedures at 50%.
Action Required
Immediately: Billing team must ensure all surgical procedures performed on the same day are submitted on a single claim with procedures on separate claim lines using appropriate modifiers. Review current billing practices for CPT codes 10000-69999 to ensure compliance with multiple procedure reduction rules. Update staff training on procedure primacy determination based on highest 5-digit allowance amounts.