COVID-19 Vaccines and Coverage  |  view in Web Browser


Blue Review

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

February 2021


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 including COVID-19: Texas Provider FAQsAdobe Acrobat Icon and COVID-19: FAQs for Medicare ProvidersAdobe Acrobat Icon.

COVID-19 Vaccines and Coverage

The federal government is working with drug companies to distribute millions of COVID-19 doses. Initially, the federal government will pay for the vaccine. BCBSTX or Self-Funded groups will cover administration of the vaccines as noted in this article.

Read More

Telehealth 2021

The onset of COVID-19 dictated the need for expanded telehealth coverage and confirmed the importance of telehealth in health care delivery. Review everything you need to know about our telehealth coverage in 2021.

Read More


Behavioral Health


Claims & Eligibility

Atrial Fibrillation and Diabetes Mellitus — Documentation and Coding Guidance

We’ve developed tips for documenting and coding Atrial Fibrillation and Diabetes Mellitus because quality documentation and accurate coding can help capture our members’ health status and promote continuity of care.

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

Updates to Clinical Practice Guidelines

Review the six clinical practice guidelines (CPG) we recently updated. CPGs are the foundation of our Condition Management programs.

Read More

FEP® Annual Medical Record Data Collection for Quality Reporting

It’s that time of year. We’ll be working with a third-party vendor – Change Healthcare – to collect medical records for HEDIS.

Read More

2020-21 Preventive Care Guidelines Are Available

We have added the updated 2020-21 Preventive Care and Wellness Guidelines to our provider website. The guidelines are updated each year related to preventive care, health screenings and immunizations.

Read More

Medicare Advantage Plans

Medicare Adds Benefit for Members with Inherited Ovarian or Breast Cancer

CMS added a benefit in 2020 for Medicare members with germline or inherited ovarian or breast cancer. The benefit covers a laboratory diagnostic test using Next Generation Sequencing. Review what we cover for services performed on or after Jan. 27, 2020.

Read More


Network Participation

Contracting and Credentialing Mid-level Providers

Based on an upcoming ClaimsXten edit, the SA modifier will be non-reimbursable. Therefore, we encourage board-certified mid-levels who are not currently contracted with BCBSTX to do so to ensure their claims are not impacted.

Read More

Prior Authorization

Infusion Site of Care Drugs Prior Authorization Update

Effective Jan. 1, 14 new procedure codes were added for Infusion Site of Care to the Prior Authorization Services Lists for ASO and Fully Insured groups. The new codes help ensure reviews for medical necessity and site of administration are being conducted according to member benefit plan details.

Read More

Utilization Management


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.

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.

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.

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 2021 Health Care Service Corporation. All Rights Reserved.

Legal and Privacy  |  Unsubscribe