Alert: Comprehensive Hospital Increase Reimbursement Program 

09/18/2024

Important Information

Blue Cross and Blue Shield of Texas Medicaid fiscal year 2024 percentages are applying to claims for 9/1/2024 and after dates of service.  A defect has been created for Rural Access to Primary and Preventive Services program, Comprehensive Hospital Increase Reimbursement Program, and Directed Payment Program for Behavioral Health Services to end date FY 2024 rate increases through 8/31/2024.

Impact

BCBSTX will only pay base contracted rates for dates of service 9/1/2024 and after until new enhanced rates are approved. We are tracking admission dates prior to 8/31/2024 with a discharge date after 9/1/2024.

The BCBSTX system defect will be corrected 9/26/2024 and we will continue to monitor for FY 2025 updates.

Discussions are pending to determine recoupments that may be necessary.

Questions

Providers, for questions or additional information, please: