CommercialPrior AuthHigh impact
2026 Prior Authorization Exemption Renewal Results Now Available
BCBS Texas·TX·Prior Authorization
Effective date
Jan 30, 2026
We identified it
May 3, 2026
Summary
Blue Cross and Blue Shield of Texas has completed its annual review of prior authorization exemptions and released renewal results. Providers whose exemptions did not meet the 90% medical necessity threshold will have their exemptions rescinded and must resume submitting prior authorization requests for those services.
Action Required
Immediately: Check Provider Correspondence Viewer in Availity Essentials for Blue Cross and Blue Shield of Texas to review your prior authorization exemption renewal results. If any exemptions were rescinded, billing team must update systems to require prior authorization for those specific services as of the rescission effective date. For services with continued exemptions, submit notifications to BCBSTX to confirm coverage and initial length of stay/units covered.