BCBS TexasMedium ImpactAdministrative

Clinical Payment and Coding Policy Updates

Published January 12, 2026Effective January 1, 2025

AI Summary

Blue Cross Blue Star Texas updated multiple clinical payment and coding policies with various effective dates. Key changes include updates to Home Health Care, Preventive Services, and Telemedicine policies, plus a new Lactation Support Services policy and modifications to non-reimbursable experimental services.

Action Required

By January 1, 2025: Billing team must review and implement updated telemedicine coding guidelines (CPCP033). By March 21, 2025: Update home health care billing procedures per CPCP005. By April 1, 2025: Review preventive services policy changes (CPCP006). By June 15, 2025: Update system to flag experimental/investigational services per CPCP028. By June 26, 2025: Prepare billing workflows for new lactation support services (CPCP043). Review full policy documents on BCBS TX provider portal for specific coding changes.

Plan Types

All Plans

States

TX

Specialties

all-specialties