High impact
Cosmetic and Reconstructive Procedures (BSC7.08)
Blue Shield of California·Effective Sep 1, 2026
Blue Shield of California updated its Cosmetic and Reconstructive Procedures policy (BSC7.08) effective September 1, 2026. The policy clarifies coverage criteria for reconstructive procedures (requiring functional improvement or normalized appearance) versus cosmetic procedures (generally non-covered). Key changes include specific requirements for chest wall deformities (pectus excavatum requiring Haller index ≥3.25 plus functional impairment), expanded guidance on benign skin lesions, and explicit exclusion of certain procedures (breast augmentation, hair transplants, tattoo removal) unless they meet reconstructive criteria or treat medical conditions like HIV-related lipoatrophy.