Blue Cross Blue Shield in New York: Anthem, Excellus and Highmark Billing Guide

New York is served by several separate Blue companies, each in its own part of the state. They are not interchangeable. Read the member's ID card, then use the section below that matches. The state regulator for all of them is the New York Department of Financial Services (hotline 800-342-3736).

Checked 10/1/26. County lines can overlap at the edges, so go by the ID card, not geography.

A. Anthem Blue Cross and Blue Shield (formerly Empire BlueCross BlueShield)

• Name change. On January 1, 2024, Empire BlueCross BlueShield became Anthem Blue Cross and Blue Shield (downstate) and Empire BlueCross became Anthem Blue Cross (upstate). Networks, contracts and rates stayed the same, both old and new ID cards are valid, and the payer ID did not change (Anthem NY notice).
• Payer IDs. 00803 for professional claims; 00303 for facility claims (Anthem NY EDI notice). Anthem's notice also says IDs WLPNT, 26375 and 27514 are non-Blue business and should not be used for Anthem Blue claims.
• Service area. 28 New York counties: 17 southeastern and 11 northeastern (Anthem about page).
• Provider Services. 800-676-BLUE (2583). Behavioral health. Carelon Behavioral Health, 1-800-397-1630 (the Carelon New York guide predates the rename and still says "Empire").
• Timely filing. Anthem announced 120 days for commercial professional claims effective 10/1/2019. Confirm the current limit before relying on it.
• Provider site. anthembluecross.com/ny/provider.

B. Excellus BlueCross BlueShield

• Company. Excellus BlueCross BlueShield, part of The Lifetime Healthcare Companies, Rochester, NY. It serves four upstate regions: Central New York, the Southern Tier, Rochester and Utica (Excellus company facts).
• Contacts. Customer Care 1-800-920-8889; Web Help Desk 1-800-278-1247; ; (provider contact page).
• Mailing address. Excellus BlueCross BlueShield, PO Box 21146, Eagan, MN 55121.
• Credentialing. Email the practitioner enrollment application to . Covered behavioral health types include clinical psychologists, LCSWs, LMHCs, LMFTs, psychiatrists (MD/DO) and psychiatric nurse practitioners. Then manage your data in CAQH (join our network).
• Provider site. provider.excellusbcbs.com.

C. Highmark Blue Cross Blue Shield (Western NY) and Highmark Blue Shield (Northeastern NY)

• Company. Highmark Western and Northeastern New York Inc., doing business as Highmark Blue Cross Blue Shield in 8 Western NY counties and Highmark Blue Shield in 13 Northeastern NY counties (Highmark).
• Counties. Western NY: Allegany, Cattaraugus, Chautauqua, Erie, Genesee, Niagara, Orleans, Wyoming. Northeastern NY: Albany, Clinton, Columbia, Essex, Fulton, Greene, Montgomery, Rensselaer, Saratoga, Schenectady, Schoharie, Warren, Washington (Highmark provider manual).
• Payer ID. 55204 (Highmark Western and Northeastern New York), per Highmark's EDI sign-up page and companion guide.
• Timely filing. 365 days from date of service in New York. Corrected claims must be filed within 15 months of the original claim, effective September 1, 2026 (Highmark).
• Phones. Provider Service Center 800-950-0051; Behavioral Health 844-946-6264 (Highmark contact sheet).
• Claims routing. Western NY network providers send all Highmark member claims, including out-of-state Highmark members, to Highmark BCBS of Western New York. Claims sent to Excellus are rejected (Highmark bulletin).
• Clearinghouse change. Highmark New York is moving clearinghouse connections to its Highmark-EDI platform with a September 2026 deadline. Payments moved to ECHO Health on January 26, 2026 (Highmark notice). Ask your clearinghouse if your claims still flow.

Healthfirst, EmblemHealth and Wellpoint are not Blue plans. They have their own rules.

Frequently asked questions

Is Empire BlueCross BlueShield still a thing?

Not by that name. On January 1, 2024, Empire BlueCross BlueShield became Anthem Blue Cross and Blue Shield downstate, and Empire BlueCross became Anthem Blue Cross upstate. The payer ID did not change.

Which Blue do I bill in Buffalo or Rochester?

Go by the member's ID card. Highmark Blue Cross Blue Shield covers Western New York counties such as Erie, and Excellus covers Rochester and other upstate regions. Counties can overlap at the edges.

Which New York Blue uses payer ID 55204?

Highmark Western and Northeastern New York, per Highmark's EDI sign-up page. Anthem uses 00803 for professional claims.

Does one New York Blue's rule apply to another?

No. Anthem, Excellus and Highmark are separate companies with their own payer IDs, addresses and deadlines.

How MCM South helps with BCBS New York

MCM South bills Blue plans for psychotherapists and psychiatrists in the states we serve. We verify benefits, submit claims electronically, follow up on denials and appeals, and handle credentialing. Get a free quote. If a BCBS New York claim is denied or credentialing stalls, we follow up for you.

MCM South currently serves practices in GA, MA, CT, TX, FL, NY, CO, TN, NC and IL, and has worked in all 50 states. If your state is not on that list, ask us. This page is operational guidance for billing, not legal advice. For real financial or legal exposure, talk to your attorney or compliance officer.

Related: Blue Cross by State · How Blue Cross Blue Shield Works · Billing Terms Glossary · CPT and E/M Code Guide · Who We Serve.