Nov. 24, 2021
Blue Cross and Blue Shield of Texas has completed the annual review of the Clinical Payment and Coding Policy (CPCP) shown below. Minor updates were added and the revised policy is effective Dec. 1, 2021 and posted to the provider website.
Coordinated Home Care /Private Duty Nursing Policy
Be sure to check eligibility and benefits before rendering service(s) to make sure a procedure is a covered benefit for the member and determine any prior authorization requirements.
Refer to Prior Authorization Lists on the Utilization Management section of our provider website to review the current CPCPs.
Clinical payment and coding policies are based on using healthcare professionals and industry standard guidelines. The clinical payment and coding guidelines are not intended to provide billing or coding advice but to serve as a reference for facilities and providers.