Prior Authorization Exemption Status via Availity® Essentials


On Sept. 12, 2022, Blue Cross and Blue Shield of Texas (BCBSTX) shared information regarding our implementation of Texas House Bill 3459 for Prior Authorization (PA) Exemption(s).

As a reminder, providers who have met the criteria to be reviewed for a Prior Authorization (PA) Exemption(s) for particular services will be able to quickly check online via Availity for their exemption status on or before to Oct. 1, 2022. This includes services that received PA exemptions managed by* BCBSTX Medical Management, Kelsey-Seybold, AIM Specialty Health® or Magellan.

* Prior authorization exemption status for prior authorizations managed by a Pharmacy Benefit Manager (PBM) may be conveyed by the PBM.

Checking Exemption Status Via Availity

You can access the Prior Authorization Exemption Status Viewer application in our BCBSTX-branded Availity Payer Spaces to determine the services you may have qualified for an PA exemption as follows:

  1. Log into Availity Essentials
  2. Select Payer Spaces from the navigation menu and choose BCBSTX
  3. Select Prior Authorization Exemption Status Viewer from the Applications tab
  4. Enter the required data elements and select Submit

The response will provide a link to the PA exemption status letter for your provider

Watch our provider website for the Prior Authorization Exemption Status User Guide. If you not currently registered for Aviality you can do so at no charge on Availity Essentials or by contacting Availity Client Services at 1-800-282-4548 to get access.

If you have notified BCBSTX your preference of receiving your notice by email or mail, you will also receive it by the method requested. If you are not currently registered for Availity, you will receive a mailed copy.  All providers still have the option of also viewing it in Availity.

More Information

Please check our Prior Authorization Exemption page.

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.