Revised CPCP003 and New CPCP042 for Emergency Department Evaluation and Management Services Coding for Facility and Professional Services, Effective 10/25/2023


Blue Cross and Blue Shield of Texas has posted the following Clinical Payment and Coding Policies (CPCP) related to Emergency Department Evaluation and Management Services Coding effective October 25, 2023:

Be sure to check eligibility and benefits before rendering service(s) to make sure a procedure is a covered benefit for the member. Refer to Clinical Payment and Coding Policies under Standards and Requirements on the provider website to review the current CPCPs.

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.