PCP Billable Lists

Billable services for capitated PCPs

Primary care physicians (PCPs), in solo or group practices, who receive capitation reimbursement for services provided to certain Horizon Blue Cross Blue Shield of New Jersey managed care members who have selected them as their PCP, may also bill for and receive fee-for-service reimbursement for the special services indicated on the following PDF.

Review Cap PCP Lists.

Information is subject to change. Physicians will be notified of any changes.

Billable services for fee-for-service PCPs

PCPs, in solo or group practices, who receive fee-for-service reimbursement for services provided to Horizon BCBSNJ managed care members, may bill for and receive fee-for-service reimbursement for all current procedural codes appropriate for their specialty. All reimbursements for services provided to Horizon BCBSNJ members are subject to the limits imposed by the physician's contract and the member's benefits.

Information is subject to change. Physicians will be notified of any change.