CPCP028 Non-Reimbursable, Experimental, Investigational and/or Unproven Services Effective 12/01/2023 Revised


Previously we posted, the Clinical Payment and Coding Policy (CPCP) for CPCP028 Non-Reimbursable Experimental, Investigational and/or Unproven Services (EIU) effective Oct. 1, 2023. A revised version was posted on 09/29/2023 on the Blue Cross and Blue Shield of Texas (BCBSTX) provider website.The changes reflect new HCPCS codes recently added.

Refer to Clinical Payment and Coding Policies under Standards and Requirements on the provider website to review the current CPCPs.

Be sure to check eligibility and benefits before rendering service(s) to make sure a procedure is a covered benefit for the member.

If you have any questions or if you need additional information, please contact your BCBSTX Network Management Representative.

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.