Jan. 24, 2020
Blue Cross and Blue Shield of Texas (BCBSTX) is implementing changes in the maximum allowable fee schedule for Blue Choice PPOSM, Blue EssentialsSM (including HealthSelectSM of Texas Network), Blue PremierSM, Blue Advantage HMOSM, MyBlue HealthSM and PAR Plan networks (collectively referred to as "Networks") effective March 1, 2020.
The specific changes and effective dates for the Network fee schedules and files are posted on the BCBSTX provider website under the Standards & Requirements tab then select General Reimbursement Information. To access this area, please obtain the password from your Network Management Office. General reimbursement information policies and fee schedule information will be posted under "Reimbursement Changes/Updates" in the "Reimbursement Schedules" section.
The methodology used to develop the maximum allowable fee schedules for BCBSTX reimbursement will be based on 2019 CMS values and posted on the provider website. The conversion factor for certain codes may vary by place of service.
If you have any questions, please contact your Network Management Office.