Prior Authorization Changes for Some Commercial and Government Program Members, Effective April 1, 2026
AI Summary
Blue Cross Blue Shield of Texas is removing prior authorization requirements for psychological/neuropsychological testing codes for commercial members and replacing revascularization codes that require prior auth for Medicare Advantage members. Changes take effect April 1, 2026.
Action Required
Before April 1, 2026: Billing team must update prior authorization workflows to remove requirements for psychological/neuropsychological testing codes for BCBSTX commercial members. For Medicare Advantage members, update prior authorization processes for revascularization procedures per new code requirements. Continue checking eligibility through Availity Essentials before rendering services to confirm current prior auth requirements.
Plan Types
Commercial, Medicare Advantage
States
TX
Specialties
psychiatry, neurology, cardiology, cardiothoracic-surgery, vascular-surgery