Check your patients’ behavioral health preauthorization requirements.  |  view in Web Browser


Blue Review

A newsletter for physician, professional, facility, ancillary and Medicaid providers

June 2019


Monthly News for Blue Cross and Blue Shield of Texas (BCBSTX) Medicaid (STAR), STAR Kids and CHIP Providers

Read this month’s Medicaid newsletter to learn about Post-Traumatic Stress Disorder Awareness Month, Magellan Healthcare’s Provider Brown Bag Series, developmental surveillance and screening components, and more.

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Notices & Announcements

New BCBSTX Network: MyBlue HealthSM

MyBlue Health is a new network that goes into effect Jan. 1, 2020, in Dallas and Harris counties.

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Network Participation Page Revisions are Here

BCBSTX has enhanced the provider onboarding process to help you obtain a provider record ID and get contracted more efficiently.

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Behavioral Health

Check Your Patients’ Behavioral Health Preauthorization Requirements

Beginning July 15, we will be improving our claims review process for behavioral health services that require preauthorization. As a reminder, checking eligibility and benefits for each member before treatment will help you confirm applicable preauthorization requirements.

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Preauthorization Information

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

There are important changes to the preauthorization requirements for your BCBSTX patients who are H-E-B partners and have the Blue Choice PPO health plan.

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

Review the list of spinal fusion surgery procedures that will require preauthorization through eviCore — not BCBSTX — beginning Aug. 1, 2019.

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BCBSTX Now Offers a Choice in Pharmacies for Specialty Medications

Accredo® and AllianceRx Walgreens Prime are now in-network pharmacies for specialty medications covered under the medical benefit for the 2019 calendar year.

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Clinical Resources

Helping Patients Find Cost-Effective Knee/Hip Replacements

Learn how BCBSTX can help you guide your patients to the most cost-effective solutions for their individual needs, like hip and knee replacements.

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Claims & Eligibility

Clinical Payment and Coding Policy Updates

BCBSTX publishes Clinical Payment and Coding policies on our website that describe payment rules and methodologies for Current Procedural Terminology (CPT®), HCPCS and ICD-10 coding when applied to claims submitted as covered services. This information is offered as a resource regarding BCBSTX payment polices and is not intended to address all reimbursement related issues. We regularly add and modify clinical payment and coding policy positions as part of our ongoing policy review processes.


Health & Wellness

In-Home Colorectal Cancer Screening Test Provided to Select Members

Select members who are 51 to 75 years old with no claim history of having a colorectal screening may be eligible to receive a home Fecal Immunochemical Test kit. Discuss the importance of colorectal cancer screening and healthy lifestyle choices with your patients.

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Network Participation


Education & Reference

Attend Free Provider Training Webinars

Whether new to these resources or if you need a refresher, there are many webinars available at no charge to learn about Availity®, eviCore, iExchange® and the remittance viewer.

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Health & Wellness Tips to Share

The Connect Community provides articles, blogs and videos, and visitors can ask questions and get answers. Topics include everything from improving well-being to explaining health coverage. Spanish is available.


Did You Know?

Did You Know (formerly In Every Issue) provides an ongoing collection of articles to assist provider offices with servicing BCBSTX members. Access this month’s articles.

BCBSTX is required to provide certain notices in all published correspondence with physicians, professional providers, and facility and ancillary providers. For the latest updates, visit the News and Updates section of the BCBSTX provider website.

Printable PDF

View a printable PDF of the non-Medicaid information in this newsletter.

Contact Us

View our quick directory of contacts for BCBSTX.

Update Your Information

Do you need to update your location, phone number, email or other important details on file with BCBSTX? Use our online forms to request information changes.

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