Update: Professional Provider Fee Schedule via Availity®

May 3, 2021

Updated May 25, 2021

The Fee Schedule tool will be available as of May 27, 2021 via Availity. Be sure to attend a training session listed below June 1-4th.

Fee schedules are a key component of your contractual relationship with Blue Cross and Blue Shield of Texas (BCBSTX). To ensure you have this information quickly, As of May 27, 2021, BCBSTX will be implementing a new online Fee Schedule viewer tool via the Availity Provider Portal for some participating professional providers. Once it’s available professional providers may use this Availity tool to electronically request up to 20 procedure codes at a time and immediately receive the currently contracted price allowance for the patient services submitted.

How to Use the Availity Fee Schedule Listing Tool:
Note: Availity Administrators must assign the “Provider Fee Schedule” role for users to gain access to this tool.

  • Log in to Availity
  • Select Claims & Payments from the navigation menu
  • Select Fee Schedule Listing
  • Select BCBSTX as the payer
  • Select your organization and Tax ID number
  • Enter the Billing National Provider Identifier (NPI) and Rendering NPI (if applicable)
  • Select the Network, Place of Service, and Provider
  • Enter the procedure code(s) and modifier(s)

You must be registered with Availity to use the new Fee Schedule tool. You can sign up today at Availity, at no charge. For registration assistance, call Availity Client Services at 1-800-282-4548. If you do not have online access, you may continue to submit your requests using the Professional Fee Schedule Request form located on our provider website.

Training
BCBSTX is hosting complimentary webinars for you to learn how to use the new Availity Fee Schedule Listing tool. To register for a webinar, click on your preferred session date below.

June 1, 2021 – 10:00 a.m. to 10:30 a.m.
June 2, 2021 – 1:00 p.m. to 1:30 p.m.
June 3, 2021 – 10:00 a.m. to 10:30 a.m.
June 4, 2021 – 1:00 p.m. to 1:30 p.m.

For More Information
We will have an instructional Fee Schedule Tool User Guide that will be added to the Provider Tools section of our website. If you have further questions, please contact our Provider Education Consultants.

Medicare Advantage and Texas Medicaid
Links to these fee schedules are available by selecting the Claims & Payments menu, Fee Schedule Listing, and then choose the appropriate Additional Fee Schedules for Medicare and/or Medicaid. They can also be found via the Resources tab in the BCBSTX-branded Payer Spaces section in the Availity portal.

 

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 any products or services provided by third party vendors such as Availity. If you have any questions about the products or services provided by such vendors, you should contact the vendor(s) directly.