March 18, 2019
Blue Cross and Blue Shield of Texas (BCBSTX) has implemented clinical payment and coding policies based on criteria developed by specialized professional societies, national guidelines (e.g. MCGTM) and the Centers for Medicare & Medicaid Services (CMS) Provider Reimbursement Manual. Additional sources are used and can be provided upon request. 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.
Effective June 18, 2019, the following policies are being implemented:
- Applied Behavior Analysis for Autism Spectrum Disorders
- Global Surgical Package
- Hernia Repair
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.
MCG care guidelines 20th Edition Copyright © 2016 MCG Health, LLC