Blue Cross Blue Shield of Michigan's extra payment to a physician office for each LDL-C or HbA1c test billed with the CPT II code that reports the result
$5
USD per lab test result reported (paid to the provider on top of the test fee), US (Michigan)
“Blue Cross Blue Shield of Michigan pays health care providers an additional $5 per billing for LDL-C and HbA1c screening lab services, as of July 15, 2013. ... CPT Category II codes must be reported on the same claim as the service to receive the additional reimbursement. These CPT Category II codes represent results of the tests in the form of a range of values.”
- Kind of source
- The payer's or seller's own page
- Read on
- 2026-11-07
- Daily check
- Quote found at the source on 2026-11-07
- What to know
- The cleanest per-result price of the plan payments: the test itself is paid separately, and the extra $5 is paid only when the result band is reported on the claim, for PPO and Medicare Advantage PPO members, which the plan says reduces the charts it must request for HEDIS. A 2013 term; the plan's August 2015 newsletter says the $5 is now included in the reimbursed fee.
- Arithmetic
- Stated per result; no arithmetic. Filed as side cost by the operator: a health plan paying a practice to code and report one result for its own quality measurement is what it costs that buyer to obtain the result, not a research licence price.
- About
- Lab results
Used in
Kept as evidence; no figure on the platform is computed from it yet.