The new Blue Cross Blue Shield fee schedule, effective Monday, July 1, 2025, is now available.
The new Blue Cross Blue Shield fee schedule, effective Monday, July 1, 2025, is now available. This fee schedule applies to services provided regardless of customer group.
The MCS Insurance Committee has developed a helpful resource featuring commonly used CPT codes, including those for Chiropractic Manipulative Therapy, Evaluation & Management, Physical Medicine, and Radiology. MCS members can access this resource on the MCS website.
Actual payments from Blue Cross will reflect the 1 percent Blueprint allocation (down from 1.5% in 2024) and 6.5 percent Physician Group Incentive Program (PGIP) allocation (up from 6% in 2024), which are deducted from the allowed amount. The Insurance Relations, Legal Affairs, and Government Relations teams continue to explore ways that chiropractors in Massachusetts can benefit from incentive programs.
Please know that MCS is actively advocating for additional fee increases on behalf of our profession.
Additional Information Regarding the 2025 Blue Cross Fee Schedule
- Fees for new and established patient E/M codes remain unchanged from 2024.
- Fees for 98940 and 98943 are also unchanged. The fee for 98941 increased by 35 cents (+0.83%), and 98942 increased by 72 cents (+1.3%).
- Many commonly used physical medicine codes (e.g., 97110, 97140, 97112, 97116) saw slight increases, though some, like neuromuscular reeducation (-2%) and infrared therapy (-1.2%), experienced reductions.
- Most x-ray codes saw slight decreases, averaging about 1%.
MCS remains committed to providing up-to-date resources and advocating for fair reimbursement for chiropractic services across Massachusetts.
