All PlansReimbursementMedium impact
PAP118 - Quarterly Maximum Allowance Updates - New
Blue Cross of Idaho·ID·Medical Policy
Effective date
Apr 1, 2024
We identified it
Jun 19, 2026
Summary
Blue Cross of Idaho has established a new policy for quarterly updates to maximum allowance amounts. Maximum allowances will be updated by the 15th of the first month of each quarter (January, April, July, October) when pricing changes are received from CMS by the 25th of the prior month.
Action Required
Monitor Blue Cross of Idaho provider communications for quarterly maximum allowance updates by the 15th of January, April, July, and October. Billing team should verify reimbursement rates in the system match updated allowances for services effective each quarter start date. Note that vaccine code allowances update annually on August 1st.