BCN - Provider-Delivered Care Management expands to BCN and BCN Advantage January 1, 2023

December 22, 2022

Dear BCN Medical Care Group Business Administrator,

I want to make sure you’re aware of an upcoming change that may bring you and your physician practices some joy during the holiday season.

Effective January 1, 2023, if you have Patient-Centered Medical Home designated providers, or mid-level providers billing under a PCMH-designated provider, these providers can bill for provider-delivered care management services for BCN and BCN AdvantageSM members.

Your providers can use the same PDCM codes they currently use with their Blue Cross Blue Shield of Michigan PPO members for their BCN and BCN Advantage members starting in January.

These codes are:

  • HCPCS Codes: G9001, G9002, G9007, G9008, S0257

  • CPT Codes: *98961, *98962, *98966, *98967, *98968, *99487, *99489

We published an introductory article about PDCM in the Jan.-Feb. 2023 issue of BCN Provider News, on page 16.

As mentioned in the article, some self-funded employer groups may elect to not participate with the PDCM program. FCA’s new Healthy Blue ChoicesSM POS health plan has chosen not to participate in PDCM.

If you have questions about PDCM, you can contact valuepartnerships@bcbsm.com.

I hope you have a wonderful holiday. I look forward to our continued partnership in 2023 to provide the very best of care to our BCN and BCN Advantage members.