BCBS TexasMedium ImpactBilling Codes

Policy Revised on Revenue Codes Requiring Supporting Codes for Outpatient Facility Claims, Effective April 14, 2025

Published January 12, 2026Effective April 14, 2025

AI Summary

Blue Cross Blue Shield of Texas is revising Clinical Payment and Coding Policy CPCP018, which governs which revenue codes require supporting CPT, HCPCS, and/or NDC codes for outpatient facility claims. The revision includes updates to bill types, affecting how outpatient facilities must submit claims with proper supporting codes.

Action Required

Before April 14, 2025: Billing team must review the revised CPCP018 policy to understand updated bill type requirements for outpatient facility claims. Update billing software and procedures to ensure proper CPT, HCPCS, and NDC codes are included with revenue codes as required by the new policy. Train staff on changes to prevent claim denials.

Plan Types

Commercial

States

TX

Specialties

all-specialties