BCBS TexasHigh ImpactAdministrative

Clinical Payment and Coding Policy Updates

Published January 12, 2026Effective December 1, 2025

AI 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.

Plan Types

All Plans

States

TX

Specialties

all-specialties

Clinical Payment and Coding Policy Updates | BCBS Texas | PolicyChanges.app