CommercialPrior AuthMedium impact
Prior Authorization Changes for Some Commercial Members, Effective Jan. 1, 2026
BCBS Texas·TX · PM&R (Physical Medicine & Rehab), Physical Therapy, Occupational Therapy +3 more·Prior Authorization
Effective date
Jan 1, 2026
We identified it
Jan 12, 2026
Summary
Effective January 1, 2026, Blue Cross Blue Shield of Texas is removing prior authorization requirements for Durable Medical Equipment (DME) codes and Electroconvulsive Therapy (ECT) codes that were previously reviewed by BCBSTX. These services will no longer require prior authorization through BCBS Texas for commercial members.
Action Required
By January 1, 2026: Billing team must update prior authorization workflows to remove DME and ECT code requirements for BCBS Texas commercial members. Update billing software rules and staff training materials to reflect that these services no longer require prior authorization through BCBSTX. Continue checking eligibility and benefits through Availity Essentials before rendering services to confirm current requirements.