The plan follows industry standard recommendations from sources such as the Centers for Medicare and Medicaid Services (CMS), Current Procedural Terminology (CPT), American Medical Association (AMA) and/or other professional organizations and societies. National Correct Coding Initiative (NCCI) editing is followed when applicable. Any exceptions are documented as Payment Policies.
NOTE: Payment Policies for Premera Blue Cross Medicare Advantage Plans The payment policies available at premera.com/wa/provider do not apply to Medicare Advantage. To access Medicare Advantage payment policies, click on the Get Started button at premera.com/wa/provider/medicare-advantage/. Premera Medicare Advantage is offered in Washington in King, Pierce, Snohomish, Thurston and Spokane counties only.