Outpatient facility revenue code billing requirements

Effective for all claims received on and after February,1 2023, in accordance with the Empire BlueCross BlueShield reimbursement policy titled Outpatient Facility Revenue Code Billing Requirements — Facility, Empire will implement additional steps to review claims submitted by facilities that contain revenue codes that do not include CPT^® or HCPCS codes when required by the National Uniform Billing Committee (NUBC).

Empire requires that current and valid CPT or HCPCS codes are reported with all revenue codes as specified in the NUBC requirements for outpatient claims. Claim lines that do not meet this requirement will be denied.

If you have questions about this policy, contact your contract manager or Provider Relationship Management account representative.