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

Oct. 24, 2019

Blue Cross and Blue Shield of Texas (BCBSTX) has updated the Clinical Payment and Coding Policies page to include the following policy additions or changes:

Evaluation and Management (E/M) Coding – Professional Provider – Added effective Jan. 25, 2020

Emergency Department Services Evaluation and Management (E/M) Services Coding – Facility Services – Changes effective Jan. 25, 2020

Clinical Payment and Coding Policies are 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.

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.


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