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For Providers
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December 2025 |
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BEHAVIORAL HEALTH |
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Review Updates to Behavioral Health Clinical Practice Guidelines
The guidelines are based on established evidence‑based standards and support decision‑making processes in member care.
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CLAIMS AND ELIGIBILITY |
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Review Prior Authorization Changes for Commercial Plans
Effective Jan. 1, 2026, prior authorization requirements for certain commercial plans are changing to reflect new, replaced or removed codes.
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EDUCATION |
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Explore Learning Opportunities
We offer free training for providers who participate in our networks. Review and sign up for sessions.
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MEDICARE |
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See Program Results for Blue Cross Medicare Advantage Dual CareSM
Every year, we measure how we’re meeting the goals for Blue Cross Medicare Advantage Dual Care Plus (HMO SNP)SM, which serves older adults and people with disabilities. See the 2024 results.
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NETWORK PARTICIPATION |
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Keep Your Record ID Active To Prevent Network Termination
If you haven’t filed a claim with your billing or rendering National Provider Identifier and Tax Identification Number with a date of service within 24 months, we may cancel your corresponding record ID, and you may be terminated from our networks. Learn how to keep your record ID active with us.
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Survey Reminder: Marketplace and Commercial Members Rate Satisfaction with Providers
Results from the 2024 Qualified Health Plan Enrollee Experience Survey and the Consumer Assessment of Healthcare Provider and Systems survey point to areas where you and your practice may have the most impact. See the results.
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PHARMACY |
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See Pharmacy Program Quarterly Update – Part 1
Changes were made to our drug lists and utilization management program. Learn about these and other pharmacy program updates.
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STANDARDS AND REQUIREMENTS |
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We’re Renaming Clinical Payment and Coding Policies to Reimbursement Policies
Starting Jan. 1, 2026, the policies will have a new name. They’ll continue to be a resource for general information on billing and coding.
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Learn About Updates to Clinical Payment and Coding Policies
We regularly add and modify CPCPs as part of our ongoing policy review. See which policies were updated and when.
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Review Active and Pending Medical Policies
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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