AdministrativeCommercialJune 30, 2022

Enhanced reimbursement for voluntary Cancer Care Quality program to be discontinued effective December 31, 2022

Beginning January 1, 2024, Empire became Anthem. This article, published under the former brand, now applies to Anthem.

Effective December 31, 2022, the enhanced reimbursement billing opportunity (S-codes) for medical oncologists selecting on-pathway drug regimens as part of the AIM Specialty Health®* Medical Oncology Solution/ Cancer Care Quality Program (CCQP) chemotherapy authorization process will be discontinued.

 

The CCQP S-codes S0353 and S0354 were activated on July 1, 2014, and have supported providers with member care coordination, and adoption of optimal, evidence-based oncology drug regimens.

 

The CCQP/AIM pathways will continue to enable the delivery of clinically appropriate cancer treatment, and supportive medication that ensures members receive high-quality, patient-centered care. The AIM pathways will remain available to medical oncologists and related subspeciality providers via the AIM provider website.

 

As the CCQP continues to evolve, the program will become a key component of more comprehensive value-based cancer care improvement initiatives, including the Oncology Medical Home Plus (OMH+) program, launching on July 1, 2022, and January 1, 2023.

 

Contact your Empire BlueCross BlueShield network representative or your oncology provider engagement liaison for more information.

 

* AIM Specialty Health is an independent company providing some utilization review services on behalf of Empire BlueCross BlueShield.

 

NYBCBS-COMM-002021-22-CPN1614

PUBLICATIONS: July 2022 Newsletter