Implementation of chargemaster‑based claims edit for ER leveling

Effective August 1, 2025, claims submitted by care providers who are reimbursed on a percentage‑of‑charge basis will undergo payment adjustments based on a customized chargemaster table. We use ER leveling to review emergency room evaluation and management (E/M) service claims for consistency with submitted claim elements. This table, specifically developed for percentage‑of‑charge care providers, will use historical claim data to determine the appropriate billed charge amount.

For questions or further clarification, please contact Provider Services via the number on the back of our member ID card.

Thank you for your cooperation and continued partnership.