Enhanced Ambulatory Patient Grouping (EAPG) Carveout Fee Schedule

Blue Cross Blue Shield of North Dakota (BCBSND) has updated the EAPG Carveout fee schedule to provide clarifying information around EAPG 119 (CAR T-CELL Immunotherapy Preparation Services) and EAPG 120 (CAR T-CELL Immunotherapy). These EAPGs have been a part of the EAPG carveout since implementation, however, specific information has not previously been shared surrounding methodology for these codes. Procedures that fall within EAPG 119 will be considered bundled and therefore non-payable. Procedures that fall within EAPG 120 are considered by report. This update does not impact claims processing as these EAPGs were just omitted from the external fee schedules but were loaded into the system correctly.

The fee schedules are available for download on BCBSND's Online Fee Schedule Portal.

Please know the portal for the online fee schedule requires activity every 120 days. If an account has been inactive for more than 120 days, the account will be disabled. If your account has been disabled due to inactivity or if you are experiencing log-in issues, please contact Support Services at 800-544-8467 during the hours of 8 a.m. – 4:30 p.m. (CT) or by email at portals@bcbsnd.com.

If you do not have an account and would like access to BCBSND’s fee schedules, please visit https://feeschedule.bcbsnd.com/FeeSchedule/.

Questions?

For questions regarding fee schedules, please email FeeSchedules@bcbsnd.com.