BCBS of North Carolina - Blue Quality Physicians Program (BQPP)

Blue Cross Blue Shield of North Carolina (BCBSNC) offers the potential for substantial Evaluation and Management (E&M) and Preventive E&M codes fee increases. How? The Blue Quality Physician Program (BQPP).

BQPP recognizes and rewards independent primary care practices committed to providing high quality, low cost, and patient centered care…” This is great news for eligible primary care practices because BQPP would give them double-digit fee increases for E&M and Preventive E&M coding fees. Practices earn a score of up to 1,000 points, and their point totals determines the reimbursement rate. To be eligible, practices must achieve Patient-Centered Medical Home (PCMH) Recognition, and their level of PCMH Recognition affects point totals.   

Along with a significant increase in reimbursement, practices gain access to “Quarterly Practice Cost Efficiency” reports. These reports give practices important data, including how they rank against peer practices in different categories. Practices gain access to “Best Practice Sharing Forums,” on which other practices share lessons learned and advice on improving the quality of care they provide. Affordable Care Act (ACA) Risk Adjustment Education is a new component to the BQPP program. Each practice will participate in webinars to learn about risk adjustment factor coding (HCC coding). BQPP is committed to helping practices continue their education and continue to improve the quality of care they provide.

“This is really important for practices and our clients in North Carolina to be aware of and take the opportunity to fully participate. BQPP represents the potential for significant reimbursement increases. It’s an exciting opportunity and a great thing that BCBSNC is doing for the practices in their state,” says Clarify’s CEO, Amber Winkler.

The following types of primary care practices are eligible to apply:

-Family Practice

-Internal Medicine

-General Practice




Important dates and deadlines for 2016:

-In 2016, practices may only apply to the BQPP during March and August.

-If your practice is due to reapply in 2016, you should have received an email on November 4, 2015 with renewal dates. If not, click here.


Click here for more information regarding eligibility and requirements, and here for application guidelines.

Contact Clarify for advice or help achieving PCMH Recognition or Renewal, so you’re eligible for increased reimbursements through the BCBSNC BQPP program.