News and Updates

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2022 NEWS AND UPDATES:

09/30/22 CPCP028 Non-Reimbursable Experimental, Investigational and/or Unproven Services Update 01/01/2023
09/28/22 CPCP006 Preventive Services Policy Update Effective Oct. 1, 2022
09/28/22 UT CARE™ Medicare PPO Effective 01/01/2023
09/27/22 Continuity of Care is Driven by Prompt Communication Upon Hospital Discharge
09/27/22 Prior Authorization Exemption Status via Availity^® Essentials
09/27/22 Importance of Early and Timely Intervention for Pre- and Post-Partum Care to Help Improve Health Outcomes
09/27/22 Keeping an Eye on Improved Provider Collaboration
09/26/22 UT CARE™ Medicare PPO (UT CARE) Effective Jan. 1, 2023
09/26/22 MyBlue Health Expansion Effective 01/01/2023
09/23/22 CPCP029 Medical Record Information Effective 12/26/2022
09/21/22 Educational Webinar Sessions
09/20/22 CPCP010 Anesthesia Information Effective 12/22/2022
09/19/22 Submitting Unlisted or Miscellaneous Codes: Billing Guidelines and Reminders
09/19/22 Annual Review: CPCP035 Unlisted/Not Otherwise Classified (NOC) Coding Policy – Effective 09/20/2022
09/16/22 New ‘Message This Payer’ Option via Availity® Essentials
09/16/22 Antidepressant Medical Management
09/16/22 Earn Continuing Education Credit through Webinar on Suicide Prevention
09/14/22 Addressing Disparities in Breast Cancer for Black Women
09/12/22 Coming Soon – Implementation of Prior Authorization Exemptions
09/12/22 Prior Authorization Changes for Inpatient Services Effective Oct. 1, 2022
09/12/22 Removal of Outpatient Services Requiring Prior Authorization Effective Sept. 18, 2022
09/08/22 How to Receive Your Prior Authorization Exemption Communication
09/08/22 Reminder: HMO Plans – PCP Selection and Referral Requirements
08/31/22 CPCP006 Preventive Services Policy Update Effective September 1, 2022
08/26/22 Health Equity and Social Determinants of Health: New Resources for Providers
08/26/22 Well onTarget Resources Reminder For Your Patients
08/25/22 Coverage Information for Monkeypox
08/16/22 Genetic Testing Prior Authorizations via AIM Submission Tip
08/15/22 Help Close Diabetes Disparity Gaps
08/15/22 Coming Soon: IVR System to Offer Prior Authorization Requests for FEP Members
08/12/22 Videos to Share on Behavioral Health Care
08/12/22 Reminders When Using the Claims Inquiry Resolution (CIR) Tool
08/11/22 ClaimsXten™ Quarterly Update Effective Dec. 5, 2022
08/10/22 Reimbursement Increase
08/10/22 Verify Your Directory Details Every 90 Days
08/10/22 Avoiding Antibiotics for Acute Bronchitis and Other Viruses
08/09/22 Pharmacy Program Updates: Quarterly Pharmacy Changes Effective Oct. 1, 2022 – Part 1
08/03/22 Are You Using These Shared Decision-Making Aids?
08/03/22 Webinars on Cross-Cultural Care for Continuing Education Credit
07/25/22 New Online Option to Confirm Medical Record Receipt Status
07/20/22 New BCBSTX MyBlue Health^SM Counties Expansion 2023
07/19/22 PEAQ Reports and Training Available in August 2022!
07/15/22 Training for Pharmacy Medical Oncology Through AIM^®
07/13/22 Reviews on Inpatient DRG Claims for BlueCard^® (Out of Area) Medicare Advantage^SM Members
07/13/22 Pharmacy Program Updates: Quarterly Pharmacy Changes Effective July 1, 2022 – Part 2
07/12/22 Update to Prior Authorization Codes for Medicare Advantage Members, Effective Oct. 1, 2022
06/30/22 Medical Oncology Prior Authorizations Transition to AIM Specialty Health® for Employees Retirement System of Texas
06/29/22 Annual Review: CPCP015 Multiple Surgical Procedures-Professional Provider Services – Effective 07/01/2022
06/28/22 Update to Prior Authorization Codes for Commercial Members, Effective Oct. 1, 2022
06/24/22 CPCP006 Preventive Services Policy Update Effective July 1, 2022
06/22/22 Language Line Supporting Cultural Competence
06/21/22 Annual Notice of Provider and Member Rights and Responsibilities
06/21/22 PEAQ^SM Provider Performance Insights (PPIs) Available in August 2022
06/16/22 Clinical Record Submission Update for Online Prior Authorization Requests
06/16/22 CT Contrast Shortage
06/15/22 Flex and Open Access for Medicare Patients and Providers
06/13/22 Importance of a Great Discharge Summary
06/13/22 Pricing Information to Display Starting in July
06/10/22 Reminder: Help Close Gaps in Care for Group Medicare Advantage Members
06/08/22 Upcoming CMS Risk Adjustment Data Validation (RADV) Medical Records Request
06/07/22 Provider Satisfaction Survey 2022
06/06/22 In-Home Test Kits for Colorectal Cancer Screening
06/06/22 Catch Up on Routine Vaccines and Well-Child Visits
05/17/22 Additional Update to Prior Authorization Codes for Medicare Members, Effective July 1
05/17/22 Earn Continuing Education Credit at Webinar on Avoiding Inappropriate Antibiotic Use
05/16/22 BCBSTX Provider Record Notification Letters Will No Longer Be Mailed Effective July 1, 2022
05/11/22 Managing Diabetes
05/06/22 ClaimsXten™ Quarterly Update Effective Aug. 22, 2022
05/05/22 Prior Authorization Code Update Effective 8/1/22 for Commercial Members
05/05/22 Alert: Availity^® Essentials Claim Status Tool Update
05/04/22 Submit Multiple Clinical Claim Appeal Requests Online
05/04/22 Pharmacy Program Updates: Quarterly Pharmacy Changes Effective July 1, 2022 – Part 1
05/03/22 Education Information Required for Directory
05/03/22 Behavioral Health Collaboration Requests
05/02/22 Annual Review: CPCP032 Intraoperative Neurophysiology Monitoring (IONM) Coding and Reimbursement Policy – Effective 05/03/2022
05/02/22 CPCP012 Hernia Repair Updated Effective 08/04/2022
04/29/22 Annual Review: CPCP033 Telemedicine and Telehealth Services Update
04/29/22 Fee Schedule Update for Procedure Codes 97151 and 97152
04/29/22 Reimbursement Increase for Outpatient Surgery Services When Performed at an Ambulatory Surgery Center
04/29/22 BCBSTX to Recommend Preferred Drugs through Enhanced Prior Authorization
04/28/22 PCP and Referral Requirements
04/28/22 PEAQ Updated Methodology and FAQ
04/27/22 CPCP028 Non-Reimbursable Experimental, Investigational and/or Unproven Services Update 8/1/22
04/21/22 CPT Category II Codes Can Help Close Care Gaps
04/21/22 Patient Appointment Access Standards
04/20/22 Update to Prior Authorization Codes for Medicare Advantage Members, Effective July 1, 2022
04/19/22 Supporting Care During and After Pregnancy
04/14/22 CPCP023 Modifier Reference Policy Effective 07/15/2022
04/13/22 CPCP021 Laboratory Panel Billing Effective 04/14/2022 Updated
04/08/22 Annual Review: CPCP034 Unbundling Policy – Professional Providers
04/05/22 Pharmacy Program Updates: Quarterly Pharmacy Changes Effective April 1, 2022 – Part 2
04/04/22 Follow-Up Care for Substance Abuse Disorders
03/30/22 Medicare Advantage Annual Health Assessment Incentive FAQs – 2022
03/30/22 Coding for Breast Augmentation and Removal for Gender Affirming Surgery
03/28/22 CPCP006 Preventive Services Policy Update Effective April 1, 2022
03/25/22 Update: New BCBSTX Lab Policies and Laboratory Management Program with Avalon Postponed
03/23/22 Advisory on Telemedicine Telehealth Services – Place of Service (POS) Codes
03/16/22 Updated: Surprise Billing Provisions of No Surprises Act
03/15/22 Change Coming to FEP Out-of-State Claims Processing
03/15/22 Update to Prior Authorization Codes for Medicare Members Effective 04/01/2022
03/14/22 Closing Gaps in Colon Care
03/11/22 CPCP014 Global Surgical Services – Professional Providers – Effective 06/13/22
03/11/22 Free Behavioral Health Webinars and Continuing Education Credit
03/11/22 Retinal Eye Exams and CPT II Coding
03/10/22 Annual Review: TXCPCP03 Surgical and Non-Surgical Services
03/07/22 Supporting Mental Health
03/04/22 Annual Review: Minor Updates to 3 Clinical Payment and Coding Policies
03/03/22 ClaimsXten™ Quarterly Update Effective June 13, 2022
03/02/22 Verify and Update Your Information Online via Availity® Provider Data Management
02/26/22 Imaging Studies for Low Back Pain
02/25/22 Update to Prior Authorization Codes for Commercial Members
02/25/22 2021 Behavioral Health Quality Improvement Program Evaluation Executive Summary
02/24/22 All Providers will now Display in Provider Finder®
02/23/22 Reminder: Claim Editing Enhancements Coming April 1
02/22/22 Medicare Advantage Flex (PPO) Plan FAQ
02/21/22 CMS Payment Adjustments for Medicare
02/18/22 Differential Diagnoses of Depression
02/18/22 Closing Gaps in Care for Group Medicare Advantage Members
02/04/22 BCBSTX 2021 Employee Volunteer of the Year
02/02/22 Evaluation & Management Coding - Professional Services Update
02/01/22 Supporting Healthy Hearts
01/31/22 POSTPONED:New Laboratory Management Program & Related Clinical Payment and Coding Policies to Begin on May 1, 2022
01/28/22 Pharmacy Program Updates: Quarterly Pharmacy Changes Effective April 1, 2022 – Part 1
01/28/22 It’s Time! Verify Your Directory Details
01/24/22 Update: Prime Therapeutics LLC Accepting Network Participation Bids Until 4/20/22
01/18/22 Prime Therapeutics LLC to Accept Facility Pharmacy Network Participation Bids
01/18/22 Surprise Billing Provisions of No Surprises Act
01/10/22 Pneumatic Compression Devices – Outpatient Use Update
01/10/22 ClaimsXten^TM Quarterly Update Effective April 11, 2022
01/10/22 Pharmacy Updates eff 1/1/2022 Part 2
01/10/22 Claim Editing Enhancements Coming - Register for a Training Webinar
01/10/22 Federal Employee Program Annual Medical Record Data Collection for HEDIS Quality Reporting
01/10/22 Annual Medical Record Data Collection for Quality Reporting begins Feb. 1