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For Providers
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April 2025 |
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APRIL SPOTLIGHT |
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Welcome to Cigna Healthcare® Medicare Advantage‑Contracted Providers
Our acquisition of Cigna Healthcare’s Medicare Advantage business is finalized. We are pleased to partner with providers to support members’ care and are committed to a smooth transition. No changes to member benefits will happen in 2025. Learn more about the acquisition and what it means for you.
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BEHAVIORAL HEALTH |
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Quality Measures Track Treatment and Follow‑Up Visits for Substance Use Disorders
You can play an important role in members’ care by discussing the signs of substance use disorders and encouraging getting help, if appropriate. Review tips to close care gaps.
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CLAIMS AND ELIGIBILITY |
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Update Your Records with New Member ID Numbers
Newly enrolled members or members who have new benefit plans may have new ID numbers. Learn why it’s important to use the entire ID number, including the three‑character prefix, when checking eligibility and benefits and submitting claims.
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MEDICAID |
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Medicaid Revalidation Due Dates Extended
The Texas Health and Human Services Commission and the Texas Medicaid & Healthcare Partnership extended revalidation dates and are addressing enrollment gaps. Providers should complete the revalidation process as soon as possible.
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Review First Quarter HCPCS Updates for Texas Medicaid
The Texas Medicaid & Healthcare Partnership implemented the first quarter 2025 Healthcare Common Procedure Coding System additions, revisions and discontinuation. The updates are effective for dates of service on or after April 1, 2025.
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Stay Updated on Medicaid News
You can find information for STAR, STAR Kids and CHIP on our Medicaid News and Updates page.
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NETWORK PARTICIPATION |
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Watch for Our Annual Satisfaction Survey
The survey measures your satisfaction with Blue Cross and Blue Shield of Texas and identifies areas where we can refine. Learn how to participate.
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STANDARDS AND REQUIREMENTS |
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Review Updates to Clinical Payment and Coding Policies
We regularly add and modify our CPCPs as part of our ongoing policy review. See which policies were updated and when.
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See Updated Policy for Billing Telemedicine and Telehealth Services
Our revised CPCP for telemedicine and telehealth services includes new coding guidance from the American Medical Association.
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Review New Policy for Billing Lactation Support Services
Effective June 26, 2025, we have a new CPCP with billing and coding guidance for lactation support services provided during the antenatal, perinatal and postpartum periods.
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Review Medical Policy Updates
Approved new or revised medical policies and their effective dates are usually posted on our website the first and 15th of each month. You can view all active and pending policies, as well as draft medical policies, and provide comments on draft policies. These policies may impact your reimbursement and your patients’ benefits.
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Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation,
a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association
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1001 E. Lookout Drive, Richardson, TX 75082
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