July 23, 2025
Effective Jan. 1, 2026, Blue Cross and Blue Shield of Texas rather than Magellan Healthcare will administer behavioral health benefits for our members with Blue Advantage HMOSM and MyBlue HealthSM.
How does this affect you? For dates of service beginning on or after Jan. 1, 2026, follow your normal process for verifying eligibility and benefits and claims submission for behavioral health services for these members as you do for other members of BCBSTX.
- Ensure you’re contracted in our Blue Advantage HMO and MyBlue Health networks by checking your contract.
- Use Availity® Essentials for checking eligibility and benefits, prior authorization requirements, claim submissions and more.
- Obtain prior authorizations through BlueApprovRSM within Availity Authorizations & Referrals.
- Submit behavioral health claims to BCBSTX for reimbursement.
- Direct claims inquiries to Availity Essentials or call the number on the member ID card.
Transition period: We will honor all authorizations and referrals on file with Magellan for up to 180 days from the effective date of Jan. 1, 2026. This means that any ongoing authorizations and referrals will be honored during this transition period, ensuring that your patients' care remains uninterrupted.
Contracting opportunities: If you’re a behavioral health provider who is not currently contracted directly with BCBSTX and would like to be, you can begin the process through our onboarding form. Learn more.
Checking of eligibility and/or benefit information is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility, any claims received during the interim period and the terms of the member’s certificate of coverage applicable on the date services were rendered.
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. Magellan Health is an independent company that provides utilization management services to BCBSTX.
BCBSTX makes no endorsement, representations or warranties regarding third-party vendors and the products and services they offer.