Provider News & Updates

Below you will find the latest on important information that may impact your practice, as well as copies of letters and notices we have released.

News and Updates

June 20, 2024

Site Visit and Medical Record Keeping Policy

An updated policy has been posted – review the policy.

June 14, 2024

New & Revised Codes for July 1, 2024 (Adaptive Maintenance)

Review full details

June 7, 2024

DME Rental to Purchase Reimbursement Payment Policy

A payment policy has been created to clarify the allowance of rental to purchase items. It can be located here.

June 6, 2024

RADV Project

We have partnered with Reveleer again this year for the medical record retrieval of 2023 claims identified in the RADV project. Outreach will begin in July. If you receive a request from Reveleer, please be sure to respond promptly following the instruction they provide.

If you have any questions on the RADV project, please contact a membre of the Risk Adjustment Department by email at or phone at (802) 371-3540.

June 4, 2024

Reminder: CAA Directory Validations

We are in the final days of the second quarter directory validation. If you have already completed, thank you.

If you have not:

Locate the directory validation email that was sent on April 6, 2024. The subject of the email is BlueCrossBlueShield of VT Directory Validation, and the sending email address is Click on the link and validate or update your information. Please ensure that you complete it for every provider listed. If you cannot locate the email in your inbox, please check your spam folder for it.

If you are not able to locate the validation from April, you will be removed from the directory, and you can be relisted once you complete the July directory validation that will be released the first week of July.

May 21, 2024

Bariatric Surgery Medical Policy

Starting June 1, 2024, the Medical Policy for Bariatric Surgery now considers revision surgery to address severe gastroesophageal reflux disease refractory to medical treatment as medically necessary. The complete policy can be reviewed on the Provider Policies area of our provider website.

May 16, 2024

Credentialing and Re-Credentialing is moving to Verisys.

Review full details here.

April 29, 2024

Medical Policy Updates for July 1, 2024

Review full details here.

April 25, 2024

CXT Upgrade will occur on July 1, 2024

Review full details here.

April 24, 2024

Feedback Informed Treatment (FIT) Workshop
May 31, 2024 | 12:00 p.m. - 1:00 p.m.

Join us for a unique opportunity to learn more about Feedback Informed Treatment (FIT). Research suggests that therapists that routinely measure client change and the therapeutic relationship have a higher rate of positive outcomes. In addition, FIT helps alert providers to problems in the therapy earlier, which allows them to respond before clients drop out. Over 100 therapists across Vermont have been using FIT for years and benefitting from participation in consultation groups that help interpret and understand the data gathered from clients.

This free, one-hour overview of FIT is available to therapists who are part of the Blue Cross Vermont network. Learn more about this valuable tool and how to be a part of a strong Vermont cohort of FIT users. Email Kristin Fletcher at for the meeting link and more information.

April 23, 2024

Community Home Infusion Administrative Reimbursement Review

Is underway, review full details here.

April 22, 2024

New Medical Policy for Private Inpatient Hospital Rooms

Review full details here.

April 22, 2024

Home Infusion Therapy Fee Schedule Analysis

We are conducting an analysis of our community fee schedules for National Drug Codes (NDC). The focus is for the categories of administrative, miscellaneous, investigational, radiopharmaceuticals, drugs "administered other than oral method", chemotherapy drugs, select pathology, laboratory, and temporary codes.

Review full details here.

April 22, 2024

State of Vermont Employer Group Benefit Changes for May 1, 2024

Review full details here.

April 17, 2024

Updated Prefix Listing

The prefix list has been updated and posted here.

April 2, 2024

Preventive Care Guide Updates

There were five additions and three clarifications to the guide for April 2024. The details are located on page 54 and 55 of the guide located here:

January 24, 2024

Updates to MD Rx for April 1, 2024

We completed our analysis of our community fee schedules for Health Care Procedure Coding System (HCPCS). The focus is for the categories of administrative, miscellaneous, investigational, radiopharmaceuticals, drugs “administered other than oral method”, chemotherapy drugs, select pathology, laboratory, bioengineered skin, and temporary codes.

Updates will be made to the community fee schedule on April 1, 2024.

Review full details

March 27, 2024

Updated New & Revised Codes for April 1, 2024 (Adaptive Maintenance)

View our latest correspondence to learn about new and revised codes.

March 7, 2024

IMPORTANT HEDIS Data Collection Update

Our HEDIS data collection is on hold until further notice. If you receive a HEDIS request for medical records for a Blue Cross VT patient from anyone, please do not release the medical records and contact the provider relations team (888) 449-0443, option 1. We will post an updated notice once we are ready to resume.   

March 1, 2024

Change Healthcare Incident Response

In immediate response to the reported cyber security incident with Change Healthcare on February 21, Change Healthcare has taken most of its applications offline. This means that Change Healthcare cannot post claims (837) files and bulk eligibility verification (270/271) transactions. If you are impacted by this incident, visit our Change Healthcare Incident Response Page for some options until connectivity is restored. 

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Provider Handbook

Access our Provider Handbook for a comprehensive reference of resources and requirements for Blue Cross providers.

Provider Handbook
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Academic Detailing and Prescription Support for Vermont Blue Rx

Our Clinical Pharmacist, Amy Stoll, PharmD, works with our providers on specific prescription questions, drug authorizations, and patient panel projects. Amy is a board-certified ambulatory care pharmacist, certified diabetes educator and has a master's degree in public health. Learn more about the services our team can provide to you.

Provider Prescription Support