May 2019
Clinical Payment and Coding Policy Updates
Blue Cross and Blue Shield of Texas (BCBSTX) has implemented clinical payment and coding policies based on criteria developed by specialized professional societies and national guidelines (e.g., MCGTM), the Centers for Medicare & Medicaid Services (CMS) Provider Reimbursement manual and others (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.
The following policies have been updated:
- Telemedicine and Telehealth Services
effective July 1, 2019 - Neonatal Intensive Care Unit (NICU) Level of Care Authorization and Reimbursement effective July 15, 2019
The following policies will be added:
- Trauma Activation effective July 1, 2019
- Laboratory Panel Billing Guidelines effective July 18, 2018
Refer to the Clinical Payment and Coding Policies section on the BCBSTX provider website for more information.
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