Coding & Reimbursement

Learn about our reimbursement policies and provider fee schedules.

Please note: Coding and reimbursement policies can be changed at any time without notification. BCBSND further reserves the right to change any contract, policy, benefit plan or process referenced in this publication without updating these publications.

Provider Fee Schedules

Access provider fee schedules through this online portal using your BCBSND credentials.

In addition to fee schedules, this online portal is a source for provider updates. BSBSND notifies providers at least 30 days before the effective date of any material modification of BCBSND’s participation agreements, at least 60 days before the effective date of the annual fee schedule changes for Health Care Institutions, and 30 days before the effective date of the annual changes for Health Care Professionals.

Not Registered? Register Now

If your account is disabled due to inactivity, contact us at 1-800-544-8467 between 8 a.m. – 4:30 p.m. CST or at portals@bcbsnd.com.

Enhanced Ambulatory Patient Grouping (EAPG)

Enhanced Ambulatory Patient Grouping (EAPG), a new outpatient reimbursement methodology, is effective July 1, 2021. The new system, 3M™ Enhanced Ambulatory Patient Grouping (EAPG), pays providers based on the resources used in an ambulatory visit. A small group of pilot providers were effective November 1, 2020.

While movement to the EAPG system is not required on July 1, 2021, BCBSND highly encourages providers to give it serious consideration. If a provider does not go onto the EAPG system on July 1, 2021 and wishes to move to the EAPG system during the 2021-2022 Fee Schedule period, the ability to move to the EAPG system will be done on a quarterly basis.

Moving to the EAPG system after July 1, 2021
Providers wanting to move to the EAPG system after July 1, 2021 will need to provide notice via email to FeeSchedules@bcbsnd.com by the first day of the month preceding the start of the quarter in which they want to move to the EAPG system.

For example:

  • September 1, 2021 for a start date of October 1, 2021
  • December 1, 2021 for a start date of January 1, 2022
  • March 1, 2022 for a start date of April 1, 2022

EAPG Frequently Asked Questions (FAQ)