Providers who are reimbursed on a fee for service basis may request fee schedule information showing applicable maximum allowable reimbursement rates payable under the terms of their agreements. These requests will be accepted twice per year.
Use the Fee Schedule Request Form on the following page to submit requests for fee schedule amounts. The form is also available on our Web site, www.bcbsga.com
If submitting a request via email, please use the online form available on our Web site, bcbsga.com under Forms and Links. After completing the form with the requested CPT codes, send this form as an attachment to email@example.com
If submitting a request via fax, fax the completed Fee Schedule Request Form to 404-467-2631.
If your request is for Behavioral Health services, please fax the completed Fee Schedule Request Form to 404-682-3154.
Please note that the inclusion of a specific procedure code on the attached report should not be viewed as an assurance or guarantee of coverage or payment. BCBSGa members’ benefit plans vary widely and are subject to change based on the contract effective dates. Claim payment and procedure coverage determinations are made in accordance with an individual member’s benefits in effect on the date that services are rendered.