All PlansAdministrativeHigh impact
Clinical Payment and Coding Policy Updates
BCBS Texas·TX·Medical Policy
Effective date
Dec 1, 2025
We identified it
Jan 12, 2026
Summary
Blue Cross Blue Shield Texas updated 10 Clinical Payment and Coding Policies affecting various specialties, with effective dates ranging from December 1, 2025 to March 20, 2026. The updates cover facility unbundling, preventive services, psychological testing, behavioral analysis, drug testing, E&M coding, corrected claims, readmissions, and point-of-care ultrasound policies.
Action Required
Before December 1, 2025: Review all 10 updated Clinical Payment and Coding Policies (CPCP002, CPCP006, CPCP008, CPCP011, CPCP020, CPCP024, CPCP025, CPCP027, CPCP030, and EIU Code List). Billing team must update coding practices and documentation requirements for affected services including facility unbundling, preventive services, psychological testing, behavioral analysis, drug testing, E&M coding, corrected claims, readmissions, and point-of-care ultrasound. Update billing software rules and provider documentation templates to align with new policy requirements across all effective dates through March 20, 2026.