COVID-19 Provider Preparedness Updates  |  view in Web Browser


Blue Review

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

August 2020


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

Read this month’s Medicaid news to learn about:

Notices & Announcements

COVID-19 Provider Preparedness Updates

As the COVID-19 crisis evolves, we’re continuing to make updates on our COVID-19 Preparedness and our COVID-19 Related News pages. Be sure to check these pages frequently for updates.

Update: New Group – Teacher Retirement System (TRS) Training

Provider training sessions related to TRS-ActiveCare benefits, prior authorization requirements and ID cards will be held Aug. 5, 13, 19 and 26. Watch your email and the website for invites and be sure to attend a session.

Read More

Behavioral Health

Behavioral Health Measures from HEDIS®

Two new behavioral health tip sheets are available to help you satisfy Healthcare Effectiveness Data and Information Set (HEDIS) measures and code appropriately. The tip sheets include measurement requirements, medical record best practices and billing codes.

Read More

Update: Behavioral Health Program Changes for HealthSelect of Texas® – Sept.1

Effective Sept. 1, 2020, psychological and neuropsychological testing for HealthSelect of Texas and Consumer Directed HealthSelectSM (HealthSelect) participants will not require prior authorization. Sept. 1, 2020, HealthSelect prior authorization lists have been updated to reflect this change.

Read More


Claims & Eligibility

ClaimsXtenTM Rule Descriptions

The ClaimsXten Rule Descriptions have been updated to reflect additions or changes to claims edits that are effective in 2020.

Read MoreAdobe Acrobat Icon

Payment Updates for Contracted Providers

We updated our payment processes on Jan. 1, 2020. Since then you may have noticed changes in the number of payments you receive from us and changes to our overpayment recovery process.

Read More

Clinical Payment and Coding Policy Updates

The Clinical Payment and Coding policies describe payment rules and methodologies for CPT®, HCPCS and ICD-10 coding for claims submitted as covered services. This information is a resource for our payment policies; it 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 process. The following have been recently added or updated:

Clinical Resources

Remember to Use In-Network Laboratories

As a reminder, per the BCBSTX Provider Manuals section B-d – Provider Roles and Responsibilities-Lab and Radiology – contracted providers must use and refer to BCBSTX-contracted laboratories. We have established relationships with contracted lab vendors depending on members’ health plans. Should you have any questions regarding this requirement, please contact your Network Management Office.

Imaging Studies for Low Back Pain

Applies to Federal Employee Program (FEP) Members
Prescription-strength analgesics and physical therapy are the preferred conservative treatment for low-back pain. Review HEDIS guidelines related to the use of imaging studies when appropriate.

Read More

Colorectal Cancer Screening at Home

Consider screening our members, your patients, who are 50 to 75 years old for colorectal cancer. Members in Blue Advantage HMOSM and Blue Advantage PlusSM HMO who have not been screened may qualify for a Fecal Immunochemical Test Kit at no extra charge.

Read More

Medicare Advantage Plans

COVID-19: FAQs for Medicare Providers

Our response to COVID-19 continues to evolve as we work to best serve our members and providers. Review FAQs regarding COVID-19 testing, treatment, telemedicine, pharmacy and more for Medicare members.

Read MoreAdobe Acrobat Icon

COVID-19 Coverage Updates for Medicare Providers

Review more FAQs for details about coverage for testing, testing-related visits and treatment for Medicare Advantage and Medicare Supplement members.

Read More



Pharmacy Program Updates: Quarterly Pharmacy Changes Effective Oct. 1, 2020 — Part 1

Review drug list changes, updates and revisions that go into effect Oct. 1.Adobe Acrobat Icon


Prior Authorization Information

AIM Prior Authorization Expansion Training

Review the steps to get ready for AIM Specialty Health® (AIM) to administer prior authorization and post-review support for some members for the following outpatient services:

  • Advanced Imaging
  • Cardiology
  • Sleep Medicine
  • Joint and Spine Surgery
  • Pain Management
  • Radiation Therapy Genetic Testing services
Read More


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 provides an ongoing collection of articles to assist provider offices with servicing BCBSTX members. Access this month’s articlesAdobe Acrobat Icon.

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

Printable PDF

View a printable PDFAdobe Acrobat Icon 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 or want to receive the Blue Review by email? Use our online form to request information changes.

Leaving Site Icon You are leaving this website/app (“site”). This new site may be offered by a vendor or an independent third party. The site may also contain non-Medicare related information. In addition, some sites may require you to agree to their terms of use and privacy policy.

Adobe Acrobat Icon File is in portable document format (PDF). To view this file, you may need to install a PDF reader program. Most PDF readers are a free download. One option is Adobe® Reader® which has a built-in screen reader. Other Adobe accessibility tools and information can be downloaded at Leaving Site Icon.

A Division of Health Care Service Corporation, a Mutual Legal Reserve Company,
an Independent Licensee of the Blue Cross and Blue Shield Association

1001 E. Lookout Drive, Richardson, TX 75082

© Copyright 2020 Health Care Service Corporation. All Rights Reserved.

Legal and Privacy  |  Unsubscribe