Prior Authorization Exemptions Reviewed for Jan. 1 through June 30, 2025
AI Summary
Blue Cross Blue Shield of Texas has reviewed and updated prior authorization exemptions for providers effective August 29, 2025. Providers who qualify for exemptions must still submit notifications to determine initial length of stay or units exempted, and may need concurrent review for services beyond the initial exemption.
Action Required
By August 29, 2025: Billing team and providers must check their prior authorization exemption status through Availity Essentials' Provider Correspondence Viewer. For any exempted services, submit notifications through Availity Essentials or by calling the member ID card number to determine initial length of stay or units covered. Continue to request concurrent review for services extending beyond initial exemption guidelines.
Plan Types
Commercial
States
TX
Specialties
all-specialties