Cardiovascular Disease Risk Assessment laboratory reimbursement
BCBSNM laboratory reimbursement and coding criteria for cardiovascular disease (CVD) risk assessment tests for members and providers; specifies which lipid and biomarker tests are reimbursable, frequencies, and exclusions.
New policy defining reimbursement criteria for CVD risk assessment laboratory testing including permitted frequencies and explicit non-reimbursable tests.
Revised 1.a.i to read every 4 years for individuals ages 18 to 79 years.
Added 'annually' to 1.d.
Added code 84512, and removed 04223T.
Added codes 0415U and 0019M.
Reimbursement Information revised for clarity and added frequency to lipid panel screening (annual for increased risk) and frequency to #4 for hs-CRP measurement.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.