Skip to main content

Fee Schedule Update for July 2020

March 27, 2020

To: All Providers

Effective July 1, 2020, we are updating our fee schedule and rates to better align with the market and standards set by Centers for Medicare & Medicaid (CMS).

To make it easier to find what you need, we’ve separated the fee schedule for 2020 into two sections:

  • Primary Care
  • Other

Primary care providers (PCPs) and specialists/all other provider types can go directly to the fee schedules that apply to their day-to-day work.

To view our current fee schedules, as well as the fee schedules that will be effective on July 1, log onto > Fee Schedules or click on the link below.

If you have any questions, please contact Provider Network Management and Operations at 1-800-666-4627 or (716) 887-2054.

Recent Articles

  • Individual Provider Recontracting Initiative
    We will be amending and restating our existing contracts. Starting next month, all directly contracted individual providers will be sent an updated contract. The New York State Department of Health (DOH) requires that each provider sign and return their amended/restated contract.
  • New Digital Provider and Facility Reference Manual
    We’ve upgraded our Provider and Facility Reference Manual, which is now available in digital format. The new manual offers a better, more interactive user experience. Here, we highlight some of the new features.
  • Updates to Screening for Hepatitis C Virus (HCV) in Adults
    Hepatitis C virus (HCV) is reportedly the most common blood infection in the country. The U.S. Preventive Services Task Force has updated the recommendation for HCV screening in March 2020 to now include all adults ages 18 to 79 without known liver disease, regardless of their risk for infection.
  • Update to Spine Preauthorization Process
    To help streamline the preauthorization process for spine procedures and injections, all these requests will be submitted directly to our Utilization Management Department beginning October 1, 2020. We will no longer require any requests to be submitted through Palladian Health.
  • Care at Home Expanded for Medicare Advantage Patients
    Beginning on July 7, more Medicare Advantage patients will be eligible to enroll in a new extension of the Care at Home program -- Care at Home℠ On Call -- which offers some urgent care in-home services. Care at Home On Call will be offered to newly enrolled Medicare Advantage members.

Working with Us

Additional Resources

We want to hear from you! Have a topic request for the next Blue Bulletin? Email us

Stay in Touch! Sign up to receive emails for provider news and information