Disclosure Notices



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Blue Cross and Blue Shield of Texas (BCBSTX) uses the BCBSTX Provider website to publish disclosure notices. The website allows BCBSTX to disclose changes in a timely and comprehensive manner.


Disclosure notices are subject to being posted either 60 or 90 days in advance of the effective date of the change with as much notice as is practicable and in compliance with applicable state or federal law.


Disclosure notices can include but are not limited to fee schedule updates and reimbursement policies, clinical payment and coding policies, provider manuals and/or benefit and medical policy changes which may impact claim payments.


If you need assistance accessing this information on the BCBSTX Provider website, please contact your Network Management office.




NoticePostedEffective

Clinical Payment and Coding Policy Update - 12/02/2020

12/02/2020 03/03/2021

Clinical Payment and Coding Policy Update - 11/19/2020

11/19/2020 02/25/2021

Telemedicine and Telehealth Clinical Payment and Coding Policy Update Including Change to Code Q3014

11/12/2020 02/12/2021

Clinical Payment and Coding Policy Update - 11/05/2020

11/05/2020 02/10/2021

Clinical Payment and Coding Policy Update - 11/03/2020

11/03/2020 03/01/2021

Update to Prior Authorizations – Jan. 1, 2021

10/29/2020 01/01/2021

New Prior Authorization Lists for Blue Cross Medicare Advantage℠ January 1, 2021

10/13/2020 01/01/2021

Clinical Payment and Coding Policy Update

10/07/2020 01/10/2021

Telemedicine and Telehealth Clinical Payment and Coding Policy Update

10/02/2020 01/01/2021

Clinical Payment and Coding Policy Update

10/01/2020 01/01/2021

Preventive Services Clinical Payment and Coding Policy Update

09/28/2020 10/01/2020

Prior Authorization Expansion to AIM®

09/28/2020 01/01/2021

Itemized Bills Required for BlueCard® Facility Claims over $100K

09/28/2020 01/01/2021

Introducing the Blue High Performance NetworkSM (Blue HPN)SM

09/23/2020 01/01/2021

Clinical Payment and Coding Policy Updates

09/18/2020 12/28/2020

Clinical Payment and Coding Policy Updates

09/01/2020 12/01/2020

Update - Physician Efficiency, Appropriateness, and Quality (PEAQ) Program Methodology

08/20/2020 09/01/2020

Correction -Clinical Payment and Coding Policy Update

08/14/2020 09/01/2020

Clinical Payment and Coding Policy Updates

08/07/2020 11/10/2020

Clinical Payment and Coding Policy Updates

07/09/2020 10/10/2020

Update: Behavioral Health Program Changes for HealthSelect of Texas® - Sept.1

07/01/2020 09/01/2020

Procedure Code Updates for Prior Authorization

06/29/2020 09/01/2020

Preventive Services Clinical Payment and Coding Policy Update

06/29/2020 07/01/2020

CPCP018 Revenue Codes Requiring CPT or HCPCS Codes Update

06/29/2020 07/01/2020

AIM Specialty Health® (AIM) to Perform Utilization Management

06/26/2020 09/01/2020

Clinical Payment and Coding Policy Updates

06/08/2020 09/15/2020

Blue Cross Medicare Advantage Prior Authorization Updates effective Sept. 1, 2020

06/03/2020 09/01/2020

Prior Authorization Code Changes for Administrative Services Only Members

06/02/2020 04/20/2020

Clinical Payment and Coding Policy Updates

05/29/2020 09/01/2020

eviCore® Prior Authorization Code Changes Effective April 20, 2020

05/22/2020 04/20/2020

Clinical Payment and Coding Policy Updates

05/09/2020 08/15/2020

2 Clinical Payment and Coding Policy Updates

04/20/2020 07/20/2020

Behavioral Health Program Changes for HealthSelect of Texas® - Sept.1

04/15/2020 09/01/2020

3 Clinical Payment and Coding Policy Updates

04/07/2020 07/10/2020

Preventive Services Clinical Payment and Coding Policy Update

03/31/2020 04/01/2020

Clinical Payment and Coding Policy Update Inpatient Readmissions

03/18/2020 06/20/2020

Clinical Payment and Coding Policy Updates

03/10/2020 06/15/2020

Three New ClaimsXtenTM Rules to be Implemented June 2020

02/20/2020 06/15/2020

Behavioral Health Program Changes for Some Provider Networks

02/19/2020 06/01/2020

Drug Testing Clinical Payment and Coding Policy

01/30/2020 05/01/2020

Two New ClaimsXtenTM Rules to be Implemented in 2020

01/20/2020 04/20/2020

Preventive Services Policy

01/08/2020 01/01/2020

NoticePostedEffective

Availity Authorization Tool via Availity® and the Deactivation of iExchange

01/03/2020 04/15/2020

Physician Efficiency, Appropriateness, and Quality (PEAQ) Program Methodology

12/27/2019 01/01/2020

Fee Schedule Update March 1, 2020

12/01/2019 03/01/2020

Blue Cross Medicare Advantage 30 Day Readmission

11/26/2019 03/01/2020

Clinical Payment and Coding Policies E&M Coding Professional Provider & Emergency Dept. Services E&M Coding – Facility Services.

10/24/2019 01/25/2020

Blue Cross Medicare Advantage 2020 New Prior Authorization Requirements

10/01/2019 01/01/2020

Clinical Payment and Coding Policies Updates

09/27/2019 01/01/2020

Itemized Bills Required for BlueCard® Claims Over $200k

09/27/2019 01/01/2020

2020 New Prior Authorization Requirements and Introduction of MyBlue HealthSM

09/25/2019 01/01/2020

Update to Clinical Payment and Coding Policy – Chiropractic Services

09/03/2019 12/03/2019

New Clinical Payment and Coding Policy

08/01/2019 11/01/2019

Updates to 3 Clinical Payment and Coding Policies

07/25/2019 10/25/2019

City Of Austin Member Preauthorization Changes

06/19/2019 01/01/2019

Change for American Airlines Members to Preauthorization Requirements for Spinal Fusion Surgery Procedures to eviCore

05/01/2019 08/01/2019

Revised Clinical Payment and Coding Policies

05/01/2019 08/01/2019

New Genetic Testing and Revised Sleep Study Preauthorization Requirements for H-E-B Partners with Blue Choice PPOSM

Updated-07/31/2019 Original -04/29/2019 08/31/2019

Clinical Payment and Coding Policy – Laboratory Panel Billing Guideline

04/16/2019 07/18/2019

Revised Texas Clinical Payment and Coding Policy – Neonatal Intensive Care Unit (NICU) Level of Care Authorization and Reimbursement Policy

04/12/2019 07/15/2019

Revised Texas Clinical Payment and Coding Policy – Telemedicine and Telehealth Services

03/28/2019 07/01/2019

New Texas Clinical Payment and Coding Policy – Trauma Activation

03/28/2019 07/01/2019

Transferring Hospital DRG Rate Calculation and Discharge Status Code Addition

03/22/2019 07/15/2019

New Clinical Payment and Coding Policy - Multiple Surgery Procedures

03/22/2019 06/22/2019

Updates to Clinical Payment and Coding Policies

03/18/2019 06/18/2019

NoticePostedEffective

CMS Jimmo Settlement

11/06/2017 11/06/2017

Two New "K" Codes for Therapeutic Continuous Glucose Monitors for Blue Cross Medicare Advantage PPOSM and Blue Cross Medicare Advantage HMOSM

10/27/2017 01/01/2018

Reimbursement Percentage Update for Modifier 52 (Reduced Services)

10/20/2017 02/01/2018

Fee Schedule Update

10/06/2017 10/01/2018

Blue Essentials Preauthorization Changes

10/02/2017 01/01/2018

Blue Advantage HMO & Blue Premier Preauthorization Changes

10/02/2017 01/01/2018

Blue Choice PPO Preauthorization Changes

10/02/2017 01/01/2018

Hospital/Facility Based Medical Group Provider Language Attachment

09/29/2017 01/01/2018

Psychological and Neuropsychological Testing

09/27/2017 10/01/2017

2018 Updates to the Blue Cross Medicare Advantage (PPO)SM and Blue Cross Medicare Advantage (HMO)SM Preauthorization Lists

09/18/2017 01/01/2018

Update to the Recoupment Policy for Blue EssentialsSM, Blue Advantage HMOSM, Blue PremierSM and HealthSelectSM Network

08/17/2017 09/15/2017

Notice of changes to Billing and Documentation Information and Requirements

08/15/2017 09/15/2017

Code-Auditing Enhancement

08/14/2017 11/12/2017

Implant Payment and Coding

08/09/2017 11/15/2017

NICU Level of Care Authorization and Reimbursement - Clinical Payment and Coding Policy Posted

06/26/2017 10/01/2017

New ClaimsXtenTM Rules to be Implemented

06/12/2017 09/18/2017

BCBSTX New Employer Group Plan – Employees Retirement System of Texas (ERS) Effective Sept. 1, 2017

05/31/2017 09/01/2017

Announcing eviCore To Begin New Preauthorization Requirements for Blue EssentialsSM, and Blue Essentials AccessSM

05/26/2017 09/01/2017

Announcing eviCore To Begin New Preauthorization Requirements for Blue Choice PPOSM, and Blue PremierSM

05/01/2017 08/01/2017

Inpatient Unbundling – Clinical Payment and Coding Policy Posted

04/24/2017 07/24/2017

Evaluation and Management of Emergency Department Coding – Clinical Payment and Coding Policy Posted

04/24/2017 07/24/2017

ClaimsXtenTM Announces Software Version Upgrade

04/19/2017 07/17/2017

Rescheduled Implementation of Additional Code Auditing Software

03/16/2017 05/07/2017

Blue Cross Medicare Advantage HMO and Blue Cross Medicare Advantage PPO New Preauthorization Requirements through eviCore effective June 1, 2017

02/24/2017 06/01/2017

Medicare Outpatient Observation Notice for Blue Cross Medicare Advantage HMOSM and Blue Cross Medicare Advantage PPOSM

02/22/2017 03/01/2017

Additional Code-auditing Software Scheduled for May 7, 2017 Implementation

01/23/2017 02/07/2017

NoticePostedEffective

Revised Effective Dates for Applied Behavioral Analysis Fee Schedule Update

12/27/2016 02/01/17 and 4/1/17

Important Changes Impacting Claims Submissions for BCBSTX Medicare Advantage Plans

12/07/2016 01/01/17

ClaimsXtenTM 1st Quarter 2017 Updates

12/05/2016 03/20/2017

Urinary Drug Test (UDT) Fee Schedule Update

10/25/16 02/01/17

Physician Payment Policies for Members enrolled in Blue Cross Medicare Advantage HMOSM and Blue Cross Medicare Advantage PPOSM

10/25/16 02/01/17

Applied Behavioral Analysis Fee Schedule Update

10/17/16 02/01/17

Update to After-Hours and Weekend Care Codes Payment Policy

10/12/16

01/01/17

Announcing Changes that Will Affect Claims Submissions for Medicare Advantage Plans

09/30/16

01/01/17

2017 Updates to the Blue Cross Medicare Advantage (PPO)SM and Blue Cross Medicare Advantage (HMO)SM Preauthorization Lists

09/29/16

01/01/17

Update to Blue Advantage HMOSM and Blue Advantage PlusSM HMO Preauthorization/Referral List – Preauthorization Required for Specific Outpatient Surgeries

09/28/16

01/01/17

Announcing a New Change for Rehabilitative and Habilitative Services for Members Enrolled in Qualified Health Plans under the Affordable Care Act

09/28/16

01/01/17

New Preauthorization Requirement for Applied Behavior Analysis for BCBSTX Members Enrolled in Blue Choice PPOSM

09/28/16

01/01/17

Notification for Inpatient Admission for Post Stabilization Care Required Within One Business Day

09/27/16

01/01/17

New Preauthorization Requirements through eviCore

06/28/16

10/03/16

ClaimsXtenTM New Specialty Pharmacy Rule – Notification of Postponement

06/01/16

08/15/16

ClaimsXtenTM Outpatient Facility Rules: Notice of Postponement for BlueCard® Host

05/24/16

07/18/16

ClaimsXtenTM 2nd Quarter 2016 Updates and New Specialty Pharmacy Rule Notification

04/18/16

07/18/16

Enroll in Medicare as a Provider with CMS

02/01/16

06/1/16


NoticePostedEffective

CPT Code 55250

02/19/13

11/01/12

Billing with National Drug Codes (NDCs) 

10/04/12

Delayed until further notice

Modifier Reimbursement Changes 

7/30/12

11/01/12

Fee Schedule Update

7/26/12

11/01/12

Billing with National Drug Codes (NDCs)

4/13/12

7/15/12

Code Auditing Update

2/7/12

5/7/12