October 2023
Blue Cross and Blue Shield of Illinois (BCBSIL) regularly reviews claims submitted by providers to help make sure benefits provided are for services included in our member’s benefit plan and meet our guidelines. Some providers are submitting claims for point-of-use convenience kits used in the administration of injectable medicines. In addition to the injectable medicines. These prepackaged kits contain not only the injectable medicine, but also supply items such as alcohol prep pads, cotton balls, disposable sterile medical gloves, povidone-iodine swabs, adhesive bandages and gauze. As a reminder, only the drug component of the kit is reimbursable to the provider.
BCBSIL periodically checks the pricing of these kits to manage costs. The cost of these convenience kits is often more than the cost of its components when purchased one item at a time. These non-drug supplies are considered as part of the practice expense for the procedure performed and no added compensation is warranted. Reimbursement for these point-of-use convenience kits may be updated based upon the U.S. Food and Drug Administration-approved drug component.
As a reminder, please provide the most appropriate care in the most cost-effective manner.
