No Referral Needed for Commercial Members to See In-Network Behavioral Health Provider
AI Summary
Blue Cross Blue Shield of Texas no longer requires referrals from primary care physicians for commercial members to see in-network behavioral health providers, in accordance with the Mental Health Parity and Addiction Equity Act. For out-of-network behavioral health referrals, PCPs must call the provider services number instead of using Availity.
Action Required
By February 9, 2026: Front desk staff must stop requiring referrals for commercial members seeing in-network behavioral health providers. Update scheduling protocols and member verification processes. For out-of-network behavioral health referrals, staff must call the provider services number on the member's ID card rather than submitting through Availity Essentials.
Plan Types
Commercial
States
TX
Specialties
psychiatry, family-medicine, internal-medicine, general-practice, pediatrics