BCBS TexasMedium ImpactDocumentation

Consider Behavioral Health Evaluations During Hospital Stays

Published January 12, 2026Effective August 11, 2025

AI Summary

Blue Cross Blue Shield Texas is encouraging hospitals to conduct behavioral health evaluations for patients admitted for medical conditions who also show mental health symptoms. When psychiatric consultations occur during hospital stays, claims must include both the behavioral health diagnosis and appropriate E&M CPT codes (99221-99223 for initial care, 99231-99233 for subsequent care).

Action Required

Immediately: Hospital billing teams must ensure claims for psychiatric consultations during medical inpatient stays include both the behavioral health diagnosis and the correct E&M CPT codes (99221-99223 for initial care, 99231-99233 for subsequent care). Update billing procedures to capture secondary behavioral health diagnoses when documented. Coordinate with medical staff to ensure proper documentation of psychiatric evaluations and time spent.

Affected Billing Codes

992219922299223992319923299233

Plan Types

All Plans

States

TX

Specialties

hospitalist, psychiatry, all-specialties