Prior Authorizations Lists for

Designated Groups

The procedures or services on the lists below may require prior authorization or prenotification by BCBSTX Medical Management or other designated vendor for certain designated groups.

  • These lists are not exhaustive.
  • The presence of codes on these lists does not necessarily indicate coverage under the member/participant’s benefits contract.
  • Consult Availity® or your preferred vendor for eligibility and benefits, the member/participant benefit booklet or contact a customer service representative to determine coverage for a specific medical service or supply.

____________________________________________________________________________________________________________________

Employees Retirement System of Texas (ERS) Prior Authorizations

Important Notice

Prior Authorization Update:
Medical Oncology Prior Authorizations Transition to AIM Specialty Health® for Employees Retirement System of Texas (ERS) effective Sept. 1, 2022 

ERS Consumer Directed HealthSelectSM In-Area (Texas)

Effective 09/01/2022:

Effective 9/1/2020 - 08/31/2022:

ERS HealthSelect of Texas® In-Area (Texas)

Effective 09/01/2022

Effective 9/1/2020 - 08/31/2022:

ERS HealthSelect of Texas® & Consumer Directed HealthSelectSM Out-Of-State

Effective 09/1/2022

Effective 9/1/2020 -08/31/2022

ERS Specialty Drug List

Effective  9/1/2021 (includes updates effective 09/01/2022):

Effective 9/1/2017 - 08/31/2021:

Related Links

Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSTX. BCBSTX makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.

Please note that checking eligibility and benefits, and/or the fact that a service or treatment has been prior authorized or predetermined for benefits is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member’s certificate of coverage applicable on the date services were rendered. If you have questions, contact the number on the member’s ID card.