CommercialCoverageMedium impact
Payment Policy Material Amendment
Arkansas Blue Cross Blue Shield·AR · Pulmonology, Critical Care, PM&R (Physical Medicine & Rehab)·Payment Policy
Effective date
Apr 15, 2025
We identified it
Jun 19, 2026
Summary
Arkansas Blue Cross and Blue Shield has updated their DMEPOS payment policy effective April 15, 2025. Key changes include adding HCPCS E0467 and E0468 to continuous rental ventilator supplies, and implementing post-payment review for inpatient DMEPOS with potential payment recovery for items provided within 3 days of discharge.
Action Required
Before April 15, 2025: Billing team must update system to bill HCPCS E0467 and E0468 monthly with one unit per calendar month using rental modifier (RR) for qualifying ventilator patients. Review inpatient DMEPOS billing workflows to avoid payment recovery - ensure DME services during inpatient stays comply with new exclusion criteria or risk post-payment recoupment.