Professional Fee Schedule Request

Please click in the appropriate county section below to access correct Professional Fee Schedule form. If unsure of a county location, rest the cursor on a county for a pop-up box to verify its name.

***Applicable to BCBSTX Contracted Physicians and Providers Only***

Important Note: Physicians/professional providers contracted/affiliated with a capitated IPA/Medical Group must contact IPA/Medical Group for instructions regarding reimbursement related questions. Additionally, physicians/professional providers not part of a capitated IPA/Medical Group but who provide services to a member whose PCP is a member of a capitated IPA/Medical Group must also contact the applicable IPA/Medical Group for instructions.

  El Paso County Dallam County Sherman County Hansford County Ochiltree County Lipscomb County Hartley County Moore County Hutchinson County Roberts County Hemphill County Oldham County Potter County Carson County Gray County Wheeler County Deaf Smith Randall County Armstrong County Donley County Collingsworth County Parmer County Castro County Swisher County Briscoe County Hall County Childress County Bailey County Lamb County Hale County Floyd County Motley County Cottle County Foard County Cochran County Hockley County Lubbock County Crosby County Dickens County King County Knox County Yoakum County Terry County Lynn County Garza County Kent County Stonewall County Gaines County Dawson County Borden County Scurry County Andrews County Martin County Howard County Mitchell County Haskell County Throckmorton County Young County Fisher County Jones County Shackelford County Stephens County Palo Pinto County Nolan County Taylor County Callahan County Ector County Midland County Glasscock County Sterling County Coke County Runnels County Coleman County Upton County Regan County Irion County Tom Green County McCulloch County Hudspeth County Concho County Eastland County Comanche County Brown County Mills County Winkler County San Saba County Loving County Ward County Crane County Culberson County Reeves County Pecos County Crockett County Schleicher County Menard County Mason County Burnet County Sutton County Kimble County Jeff Davis County Presidio County Brewster County Terrell County Val Verde County Edwards County Baylor County Wilbarger County Hardeman County Wichita County Clay County Archer County Jack County Montague County Cooke County Grayson County Wise County Denton County Collin County Parker County Tarrant County Dallas County Hunt Rockwall County Kaufman County Hood County Erath Somervell County Johnson County Ellis County Navarro County Hill County Bosque County Fannin County Lamar Delta County Bowie County Hopkins County Red  River Franklin County Titus County Camp County Morris Cass County Wood Rains County Upshur County Marion County Van Zandt County Gregg Smith County Harrison County Henderson County Freestone County Anderson County Cherokee County Rusk County Panola County Hamilton County McLennan County Coryell County Falls County Lampasas County Bell County Llano County Williamson County Milam County Burleson County Gillespie County Kerr County Kendall County Blanco County Travis County Hays County Lee County Bastrop County Comal County Caldwell County Guadalupe County Gonzales County Fayette County Limestone County Robertson County Leon Madison County Houston County Trinity County Angelina County Nacogdoches County Shelby County San Augustine County Sabine County Brazos County Grimes County Walker County Polk County San Jacinto Liberty County Tyler County Jasper County Newton County Orange County Hardin County Jefferson County Montgomery County Washington County Austin County Waller County Harris County Chambers County Colorado County Fort Bend County Lavaca County Wharton County Galveston County Dewitt County Goliad County Victoria County Calhoun County Jackson County Matagorda County Brazoria County Kinney County Real County Bandera County Uvalde County Medina County Bexar County Wilson County Karnes County Bee County Refugio County Aransas County Aransas County San Patricio County Nueces County Maverick County Zavala County Frio County Atascosa County Dimmit County La Salle County McMullen County Live Oak County Webb County Duval County Jim Wells County Kleberg County Zapata County Jim Hogg County Brooks County Kenedy County Starr County Hidalgo County Willacy County Cameron County