BCBS TexasMedium ImpactDocumentation

Reinforce Prenatal and Postpartum Care to Support Whole Health

Published May 3, 2026Effective April 16, 2026

AI Summary

Blue Cross Blue Shield of Texas is reinforcing HEDIS quality measures for prenatal and postpartum care, requiring specific timing and documentation for visits, depression screening with standardized instruments, and follow-up care within 30 days of positive screenings.

Action Required

Immediately: OB-GYN and primary care providers must ensure prenatal visits are scheduled within 14 weeks of gestation and postpartum visits occur between 7-84 days after delivery. Implement standardized depression screening tools (PHQ-9, PHQ-2, or Edinburgh Postnatal Depression Scale) during pregnancy and postpartum visits. For positive screenings, provide follow-up care within 30 days including evaluation, risk assessment, referrals, or treatment. Update documentation to support HEDIS reporting and coordinate care between behavioral health and medical providers.

Plan Types

Commercial

States

TX

Specialties

ob-gyn, family-medicine, internal-medicine, general-practice, psychiatry