Reimbursement for EXPAREL

Blue Cross Blue Shield of North Dakota (BCBSND) reviewed guidance from the Centers for Medicare and Medicaid Services (CMS) related to separately reimbursing the use of EXPAREL for postsurgical pain management in Hospital Outpatient (HOPFS) and Ambulatory Surgical Centers (ASC).

To address the use of EXPAREL as an option to reduce Opioid reliance, Healthcare Common Procedure Coding System (HCPCS) code C9290 was added to the HOPFS and the ASC fee schedules for separate reimbursement effective July 1, 2020.

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