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Blue Review

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

May 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 Blue Review Special Bulletin

Extra, extra! Did you see our special edition of Blue Review covering COVID-19 news and updates? Be sure to check it out.

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Provider Information on COVID-19 Coverage

Get information all in one place. We appreciate the care you are providing our members during the COVID-19 pandemic. With the evolving changes, you can use the Provider Information on COVID-19 Coverage page to get the most current information.

Alert: iExchange® Deactivation Extended

In response to COVID-19, the iExchange deactivation planned for April 15, has been temporarily suspended to allow you additional time to convert to the Availity® Authorizations & Referrals tool during this pandemic.

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Have You Heard About the New Texas Surprise Billing Law?

What’s new: A Texas law protects health plan members who received medical care on or after Jan. 1, 2020, from surprise bills in many situations where a member doesn’t have a choice in where to get care.

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Behavioral Health

Behavioral Health Program Changes for HealthSelect of Texas® Effective Sept. 1

As a reminder, starting June 1, 2020, we will administer behavioral health (BH) benefits for Blue EssentialsSM, Blue Essentials AccessSM, Blue PremierSM and Blue Premier AccessSM provider networks. Magellan Healthcare® will no longer administer behavioral health benefits for these members. Also, BH services for HealthSelect of Texas and Consumer Directed HealthSelectSM participants will transition on Sept. 1, 2020.

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

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


Claims & Eligibility

Billing for Point-of-Use Convenience Kits

You should know: Only the drug component(s) of point-of-use convenience kits will be reimbursed to providers. Why? Often, the cost of these convenience kits is more than the cost of its components when purchased one item at a time.

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Check Eligibility and Benefits: Don’t Skip this Step!

The Clinical Payment and Coding policies published on our website describe payment rules and methodologies for CPT®, HCPCS and ICD-10 coding for claims submitted as covered services. This information is offered as 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:


Education & Reference

Blue Cross Medicare Advantage® Orientation Training Webinar

Register today for a webinar to learn about providing the highest quality of care to our Medicare Advantage members and providing timely plan updates.

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Complimentary Webinar Trainings Available

Do you have new staff or need a refresher about electronic options? If yes, we have added complimentary educational webinar sessions on the BCBSTX provider website for provider billers, utilization areas and administrative departments. Topics include Availity 101, Availity Authorizations & Referrals and Remittance Viewer. Please visit the Provider Training page on our provider website throughout the year to view available training topics and sign up for sessions.

Network Participation


Prior Authorization Information


Health & Wellness


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 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.

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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.

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