Medicare Advantage Provider Manuals and Other Information

Access the BlueCross Medicare Advantage Provider Manuals or learn more about the CPT Category II coding incentive.

BlueCross TotalSM PPO

This manual provides you with an overview of the BlueCross Total PPO plans and medical management programs. These plans offer a network of preferred providers, and members can receive benefits both in and out of network.
Updated: June 2019

BlueCross SecureSM HMO 

This manual provides you with an overview of the BlueCross Secure HMO plans and medical management programs. Each of these plans offer a network of providers. Members should receive services only from providers within their respective network. Out of network services are NOT covered (members should refer to their Evidence of Coverage for exceptions). 
Updated: June 2019

CPT Category II Coding Incentive for In-Network Providers

Network providers can earn incentives for billing certain CPT Category II codes as part of the Healthcare Effectiveness Data and Information Set (HEDIS®) clinical measures. This incentive is applicable to Medicare Advantage members for dates of service on or after January 1, 2018.