Update to Claims Pricing Manual – Clarification to Claim-Level Pricing

Blue Cross and Blue Shield of Kansas (BCBSKS) has updated language within the Claims Pricing Manual to clarify how certain services are reimbursed.

The updated language clarifies that when a claim-level CPT or HCPCS code does not have an assigned MAP, the claim will be reimbursed at the line level, with non-MAP’d codes priced according to the provider’s contract.

This clarification helps ensure consistent interpretation of how claims are priced when a MAP amount is not available for claim-level codes, supporting more transparent and predictable reimbursement outcomes.

If you have questions about this update or how it may impact your claims, please contact your Provider Relations representative.