Bundled Services

The Alliance will not separately reimburse for certain Current Procedural Terminology (CPT®) and Healthcare Common Procedure Coding System (HCPCS) codes identified by the Centers of Medicare and Medicaid Services (CMS) National Physician Fee Schedule (NPFS) Relative Value File with designated status indicator of “B” for bundled service.

Bundled Codes are not reimbursable services regardless of whether they are billed alone or in conjunction with other services on the same date. If these services are covered, allowance for them is subsumed by the allowance for the services to which they are incidental. (An example is a telephone call from a hospital nurse regarding care of a patient.) Services without direct face-to-face contact are considered to be a component of the overall medical management service.

The Alliance Bundled Service List