Florida Blue policies

Search Florida Blue's public medical, payment and drug policies by CPT or HCPCS code, keyword or policy number, with links to the payer's own documents. Links open the payer's own document; check its current version before relying on it.

87 public policies Substrate tracks for Florida Blue, by title.

Florida Blue policies
PolicyDetailsCodesSource
3D Rendering of Tomographic Modalities10-001 · Commercial, Medicaid2Original policy ↗
AcupunctureCommercial19Original policy ↗
Add On Codes15-044 · Commercial, Medicaid4Original policy ↗
Administration of Injections and Infusions10-033 · Commercial, Medicaid36Original policy ↗
After Hours and Weekend Care10-002 · Commercial, Medicaid6Original policy ↗
AmbulanceCommercial18Original policy ↗
Ambulance Services18-061 · Commercial, Medicaid11Original policy ↗
Ambulatory Infusion CenterCommercial12Original policy ↗
Ambulatory Surgical CenterCommercial4,773Original policy ↗
Anatomical Modifier Requirement Policy23-081 · Commercial—Original policy ↗
Anesthesia Services10-003 · Effective Aug 13, 2026 · Commercial, Medicaid43Original policy ↗
B-Status Codes10-004 · Commercial, Medicaid4Original policy ↗
Bilateral Procedures - Professional & Institutional Billing10-005 · Commercial, Medicaid1Original policy ↗
Birthing CenterCommercial18Original policy ↗
Care Coordination Services15-041 · Commercial, Medicaid21Original policy ↗
Care Review, Coordination of Benefits, Appeals and Grievances, Quality and Compliance Programs, Self-Service Tools and ResourcesCommercial—Original policy ↗
Claim Submission, Billing GuidelinesCommercial262Original policy ↗
Co-Surgeons (Two Surgeons)10-024 · Commercial, Medicaid—Original policy ↗
Consultation Services17-055 · Effective May 14, 2026 · Commercial, Medicaid22Original policy ↗
Discontinued Procedure-53 Modifier10-032 · Commercial, Medicaid4Original policy ↗
Durable Medical EquipmentCommercial2,067Original policy ↗
Emergency Department Evaluation & Management Services *NEW*26-088 · Commercial, Medicaid7Original policy ↗
Evaluation & Management for Office or Other Outpatient Services21-070 · Commercial, Medicaid39Original policy ↗
Evaluation & Management Services by Physicians in the Same Group Practice20-068 · Commercial, Medicaid—Original policy ↗
Facility Reimbursement for Clinic Services22-077 · Commercial—Original policy ↗
Global Surgery Package10-009 · Commercial, Medicaid6Original policy ↗
Hearing Aid DealerCommercial114Original policy ↗
Hospital Inpatient or Observation Discharge Policy21-075 · Commercial, Medicaid10Original policy ↗
Hospital Related Services for or Leading to an Inpatient Admission17-056 · Effective Aug 13, 2026 · Commercial12Original policy ↗
Hospital Related Services for Outpatient Claims22-076 · Commercial—Original policy ↗
Hyperbaric Oxygen TherapyCommercial10Original policy ↗
Increased Procedural Services (Modifier-22)10-034 · Commercial, Medicaid2Original policy ↗
Independent Clinical LaboratoryCommercial1,814Original policy ↗
Independent Diagnostic Testing CenterCommercial1,140Original policy ↗
Initial Hospital Inpatient or Observation Evaluation & Management Services16-047 · Effective Jul 9, 2026 · Commercial, Medicaid10Original policy ↗
Inpatient Clotting Factor Reimbursement and Billing - Medicare Advantage24-08434Original policy ↗
Institutional Payment Programs and Charge Based Reimbursement for Commercial Products19-066 · Commercial, Medicaid—Original policy ↗
Institutional Reimbursement as Inpatient versus Outpatient23-079 · Commercial—Original policy ↗
Institutional Supplies Policy20-072 · Commercial17Original policy ↗
Laboratory Panels and Other Lab Services15-040 · Commercial, Medicaid79Original policy ↗
Lactation Consultation Services25-087 · Commercial, Medicaid7Original policy ↗
Manual for Physicians and ProvidersCommercial443Original policy ↗
Maximum Units of Service10-012 · Commercial, Medicaid—Original policy ↗
Medical Pharmacy PA/UM Drug ListCommercial602Original policy ↗
Modifier Reference10-011 · Commercial, Medicaid—Original policy ↗
Multiple Diagnostic Cardiovascular Procedure Reduction15-045 · Commercial, Medicaid2Original policy ↗
Multiple Diagnostic Ophthalmology Procedure Reduction15-046 · Commercial, Medicaid2Original policy ↗
Multiple Imaging Reduction10-037 · Commercial, Medicaid12Original policy ↗
Multiple Procedure Reduction - Home Infusion Therapy Per-Diem15-039 · Commercial, Medicaid42Original policy ↗
Multiple Surgical Procedure Reduction (Including Multiple Endoscopic Procedure Reduction)10-026 · Effective Aug 13, 2026 · Commercial, Medicaid2Original policy ↗

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Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.