All PlansAdministrativeMedium impact
Claims Reminders for Behavioral Health Services
BCBS Texas·TX · Psychiatry, Family Medicine, Internal Medicine +1 more·General
Effective date
May 22, 2025
We identified it
Jan 12, 2026
Summary
Blue Cross Blue Shield of Texas issued reminders for behavioral health billing emphasizing that out-of-network providers must bill under their own NPI (not pass-through billing), trainees must have direct supervision 100% of the time, and a future HL modifier will be required for trainee services. These same requirements apply to physical health services.
Action Required
Immediately: Review current billing practices to ensure out-of-network providers in group practices bill under their own NPI, not the supervising provider's NPI. Verify all trainee services have 100% direct supervision documented. Prepare for future HL modifier implementation for trainee services (do not use until BCBSTX notification). Update documentation to support direct supervision requirements.