Summary
Blue Shield of California's Investigational Services policy (BSC9.01) has an effective date of 09/01/2026. It defines healthcare services as investigational when all three apply: testing is not complete, the efficacy and safety of the service in human subjects are not yet established, and the service is not in wide usage. The policy addresses services that are not covered because they are considered investigational, and its code table lists CPT codes from 22526 through 1025T, many of them effective 1/1/2026.
Get alerts when payers change rules like this one
We check Blue Shield of California and other payers every day and email you when a change matches your specialty and state.
Get Blue Shield of California alertsPolicy Monitoring is free. No card required.
What to do
Action · 2 steps
01Already effective 09/01/2026: Billing team: For the codes listed in this policy, check current applicability before billing, because these services are not covered when they are considered investigational.
02Benefit determinations follow the member's health services contract language, which controls if it conflicts with this policy.
Codes mentioned
2252622527225863683784112
Original notice
Investigational Services (BSC9.01)
blueshieldca.com · Always check the source before changing claims.