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CommercialCoverageLow impact

Phototherapy

Blue Cross & Blue Shield of Mississippi·MS · Dermatology·Medical Policy
Effective date
Not stated
We identified it
Jun 20, 2026
Days to comply

Summary

This is a complete phototherapy policy for Blue Cross Blue Shield of Mississippi that specifies covered conditions, treatment requirements, and exclusions. The policy requires dermatologist ordering and limits treatments to 24 sessions over 8 weeks unless medical necessity is established.

Action Required

Action needed
Review current phototherapy billing practices to ensure compliance with BCBS Mississippi requirements: verify dermatologist ordering for all phototherapy services, confirm covered diagnoses match policy list, and establish medical necessity documentation for treatments exceeding 24 sessions.

Affected Billing Codes

96900
96910
96912
96913
97028
A4633
E0202
E0691