2024 Disclosure Notices

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.

Disclosures related to Clinical Payment and Coding Policies (CPCP) will indicate CPCP and the policy number followed by the title of the policy.

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

DISCLOSURE NOTICE POSTED EFFECTIVE
TXCPCP03 Surgical and Non-Surgical Services Updated Effective 09/06/2024 06/05/2024 09/06/2024
Changing Prior Authorization to Recommended Clinical Review Effective Sept. 1 for TRS Participants 05/31/2024 09/01/2024
Utilization Management Update Including Change to Recommended Clinical Review Effective Sept. 1, 2024, for ERS Plans  05/31/2024 09/01/2024
Update: Our Revised Clinical Payment and Coding Policy for Anesthesia Services now Effective Aug. 14, 2024 02/29/2024 & Updated 05/30/2024 08/14/2024
Updated PEAQSM Methodology Is Now Available 05/29/2024 05/30/2026
Claim Processing Enhancements for ERS Effective Sept. 1, 2024 05/28/2024 09/01/2024
CPCP029 Medical Record Documentation Updated Effective 07/24/2024 04/23/2024 07/24/2024
Prior Authorization Code Updates for Medicare Advantage Members, Effective July 1, 2024 04/17/2024 07/01/2024
Prior Authorization Code Changes for Commercial Members Effective 07/01/2024 03/29/2024 07/01/2024
CPCP025 Corrected Claim Submission Updated Including Changes for Late/Added Charges 03/28/2024 07/01/2024
CPCP028 Non-Reimbursable, Experimental, Investigational and/or Unproven Services (EIU) Update - Effective 07/01/2024 03/26/2024 07/01/2024
See Our Revised Clinical Payment and Coding Policy for Billing Anesthesia Services Effective 06/01/2024 (Updated Effective date to 08/14/2024 on 5/30/2024)
02/29/2024/Updated 05/30/2024
Changed from 06/01/2024 to 08/14/2024
CPCP033 Telemedicine and Telehealth/Virtual Health Care Services Policy Updated Effective 05/01/2024 02/29/2024 05/01/2024
Claim Editing Changes for Emergency Department Services 07/24/2023 and Updated 02/28/2024 04/01/2024
CPCP028 Non-Reimbursable, Experimental, Investigational and/or Unproven Services (EIU) Update- Effective 05/15/2024 02/14/2024 -Updated 03/26/2024 05/15/2024
Recommended Clinical Review Procedure Code List Changes for Commercial Members Effective May 15, 2024 02/14/2024 05/15/2024
Introducing Smart RxAssist via HealthSmartRx® 01/26/2024 05/01/2024
CPCP023 Modifier Reference Policy Update– Effective 04/19/2023 01/18/2024 04/19/2024
Prior Authorization Code Updates for Medicare Advantage Members Effective April 1, 2024 01/11/2024 04/01/2024
Update to Prior Authorization Code Changes for Commercial Members Effective April 1, 2024 01/08/2024 04/01/2024