CommercialReimbursementMedium impact
PAP257 - Multiple Procedures - Removed bilateral exception from hospitals paid at percent of billed charge.
Blue Cross of Idaho·ID · Orthopedics, Ophthalmology, General Surgery +3 more·Medical Policy
We identified it
Jun 19, 2026
Summary
Blue Cross of Idaho has removed the bilateral exception for hospitals paid at percent of billed charges when applying multiple procedure payment reduction rules. This means bilateral procedures at hospitals will now be subject to the same multiple procedure payment reductions as other facilities.
Action Required
Immediately: Billing team must update payment expectations for bilateral procedures performed at hospitals under Blue Cross of Idaho contracts. Review and adjust financial counseling scripts to inform patients that bilateral procedures may now have reduced reimbursement rates. Monitor initial claims to verify new payment patterns and adjust revenue cycle processes accordingly.