Blue Cross and Blue Shield of Illinois policy

Preventive Services Policy

Preventive Services Policy is a public Blue Cross and Blue Shield of Illinois policy (policy RP006, effective Jul 1, 2026). It lists 599 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.

View the original policy (PDF) ↗

Payer
Blue Cross and Blue Shield of Illinois
Policy number
RP006
Effective
Jul 1, 2026
Line of business
Commercial, Medicaid
States
IL
Source
www.bcbsil.com

Codes in this policy

The CPT and HCPCS codes the policy names. A policy can name a code it excludes.

CodeOther Blue Cross and Blue Shield of Illinois policies
0065UPolicies naming 0065U
00812Policies naming 00812
00813Policies naming 00813
0096UPolicies naming 0096U
01922Policies naming 01922
0210UPolicies naming 0210U
0333TPolicies naming 0333T
0464UPolicies naming 0464U
0500TPolicies naming 0500T
0633TPolicies naming 0633T
0634TPolicies naming 0634T
0635TPolicies naming 0635T
0636TPolicies naming 0636T
0637TPolicies naming 0637T
0638TPolicies naming 0638T
0836TPolicies naming 0836T
10004Policies naming 10004
10005Policies naming 10005
10006Policies naming 10006
10007Policies naming 10007
10008Policies naming 10008
10009Policies naming 10009
10010Policies naming 10010
10011Policies naming 10011
10012Policies naming 10012
10021Policies naming 10021
11976Policies naming 11976
11981Policies naming 11981
11982Policies naming 11982
11983Policies naming 11983
19030Policies naming 19030
19081Policies naming 19081
19082Policies naming 19082
19083Policies naming 19083
19084Policies naming 19084
19085Policies naming 19085
19086Policies naming 19086
19100Policies naming 19100
19101Policies naming 19101
19281Policies naming 19281
19282Policies naming 19282
19283Policies naming 19283
19284Policies naming 19284
19285Policies naming 19285
19286Policies naming 19286
19287Policies naming 19287
19288Policies naming 19288
36415Policies naming 36415
36416Policies naming 36416
44388Policies naming 44388
44389Policies naming 44389
44392Policies naming 44392
44394Policies naming 44394
44401Policies naming 44401
44404Policies naming 44404
45330Policies naming 45330
45331Policies naming 45331
45333Policies naming 45333
45335Policies naming 45335
45338Policies naming 45338
45346Policies naming 45346
45378Policies naming 45378
45380Policies naming 45380
45381Policies naming 45381
45384Policies naming 45384
45385Policies naming 45385
45388Policies naming 45388
57170Policies naming 57170
58300Policies naming 58300
58301Policies naming 58301
58340Policies naming 58340
58565Policies naming 58565
58600Policies naming 58600
58605Policies naming 58605
58611Policies naming 58611
58615Policies naming 58615
58661Policies naming 58661
58670Policies naming 58670
58671Policies naming 58671
58700Policies naming 58700
71271Policies naming 71271
74263Policies naming 74263
74740Policies naming 74740
76376Policies naming 76376
76377Policies naming 76377
76641Policies naming 76641
76642Policies naming 76642
76706Policies naming 76706
76942Policies naming 76942
76977Policies naming 76977
77002Policies naming 77002
77012Policies naming 77012
77021Policies naming 77021
77046Policies naming 77046
77047Policies naming 77047
77048Policies naming 77048
77049Policies naming 77049
77053Policies naming 77053
77054Policies naming 77054
77061Policies naming 77061
77062Policies naming 77062
77063Policies naming 77063
77065Policies naming 77065
77066Policies naming 77066
77067Policies naming 77067
77078Policies naming 77078
77080Policies naming 77080
77081Policies naming 77081
78350Policies naming 78350
78351Policies naming 78351
80050Policies naming 80050
80053Policies naming 80053
80055Policies naming 80055
80061Policies naming 80061
80074Policies naming 80074
80076Policies naming 80076
80081Policies naming 80081
80503Policies naming 80503
80504Policies naming 80504
80505Policies naming 80505
80506Policies naming 80506
81007Policies naming 81007
81025Policies naming 81025
81162Policies naming 81162
81163Policies naming 81163
81164Policies naming 81164
81165Policies naming 81165
81166Policies naming 81166
81167Policies naming 81167
81212Policies naming 81212
81215Policies naming 81215
81216Policies naming 81216
81217Policies naming 81217
81307Policies naming 81307
81308Policies naming 81308
81528Policies naming 81528
82247Policies naming 82247
82248Policies naming 82248
82270Policies naming 82270
82274Policies naming 82274
82465Policies naming 82465
82565Policies naming 82565
82570Policies naming 82570
82575Policies naming 82575
82947Policies naming 82947
82948Policies naming 82948
82950Policies naming 82950
82951Policies naming 82951
82952Policies naming 82952
83020Policies naming 83020
83021Policies naming 83021
83030Policies naming 83030
83033Policies naming 83033
83036Policies naming 83036
83051Policies naming 83051
83361Policies naming 83361
83655Policies naming 83655
83700Policies naming 83700
83718Policies naming 83718
83719Policies naming 83719
83721Policies naming 83721
84030Policies naming 84030
84443Policies naming 84443
84478Policies naming 84478
85004Policies naming 85004
85013Policies naming 85013
85014Policies naming 85014
85018Policies naming 85018
85025Policies naming 85025
85027Policies naming 85027
86480Policies naming 86480
86481Policies naming 86481
86580Policies naming 86580
86592Policies naming 86592
86593Policies naming 86593
86631Policies naming 86631
86632Policies naming 86632
86689Policies naming 86689
86701Policies naming 86701
86702Policies naming 86702
86703Policies naming 86703
86704Policies naming 86704
86705Policies naming 86705
86706Policies naming 86706
86707Policies naming 86707
86780Policies naming 86780
86803Policies naming 86803
86804Policies naming 86804
86850Policies naming 86850
86870Policies naming 86870
86900Policies naming 86900
86901Policies naming 86901
87081Policies naming 87081
87086Policies naming 87086
87088Policies naming 87088
87110Policies naming 87110
87210Policies naming 87210
87270Policies naming 87270
87285Policies naming 87285
87320Policies naming 87320
87340Policies naming 87340
87341Policies naming 87341
87389Policies naming 87389
87390Policies naming 87390
87391Policies naming 87391
87490Policies naming 87490
87491Policies naming 87491
87492Policies naming 87492
87494Policies naming 87494
87520Policies naming 87520
87521Policies naming 87521
87534Policies naming 87534
87535Policies naming 87535
87536Policies naming 87536
87537Policies naming 87537
87538Policies naming 87538
87539Policies naming 87539
87590Policies naming 87590
87591Policies naming 87591
87592Policies naming 87592
87623Policies naming 87623
87624Policies naming 87624
87625Policies naming 87625
87626Policies naming 87626
87800Policies naming 87800
87801Policies naming 87801
87806Policies naming 87806
87810Policies naming 87810
87850Policies naming 87850
88108Policies naming 88108
88112Policies naming 88112
88141Policies naming 88141
88142Policies naming 88142
88143Policies naming 88143
88147Policies naming 88147
88148Policies naming 88148
88150Policies naming 88150
88152Policies naming 88152
88153Policies naming 88153
88155Policies naming 88155
88164Policies naming 88164
88165Policies naming 88165
88166Policies naming 88166
88167Policies naming 88167
88172Policies naming 88172
88173Policies naming 88173
88174Policies naming 88174
88175Policies naming 88175
88177Policies naming 88177
88184Policies naming 88184
88185Policies naming 88185
88262Policies naming 88262
88271Policies naming 88271
88274Policies naming 88274
88291Policies naming 88291
88300Policies naming 88300
88302Policies naming 88302
88304Policies naming 88304
88305Policies naming 88305
88307Policies naming 88307
88309Policies naming 88309
88312Policies naming 88312
88313Policies naming 88313
88325Policies naming 88325
88331Policies naming 88331
88332Policies naming 88332
88341Policies naming 88341
88342Policies naming 88342
88344Policies naming 88344
88360Policies naming 88360
88364Policies naming 88364
88365Policies naming 88365
88367Policies naming 88367
88374Policies naming 88374
88377Policies naming 88377
88720Policies naming 88720
90380Policies naming 90380
90381Policies naming 90381
90382Policies naming 90382
90460Policies naming 90460
90461Policies naming 90461
90471Policies naming 90471
90472Policies naming 90472
90473Policies naming 90473
90474Policies naming 90474
90480Policies naming 90480
90481Policies naming 90481
90611Policies naming 90611
90619Policies naming 90619
90620Policies naming 90620
90621Policies naming 90621
90623Policies naming 90623
90624Policies naming 90624
90630Policies naming 90630
90632Policies naming 90632
90633Policies naming 90633
90634Policies naming 90634
90635Policies naming 90635
90636Policies naming 90636
90644Policies naming 90644

And 299 more in the original policy.

All Blue Cross and Blue Shield of Illinois policies

Disclaimer

The information provided on this page is for general informational purposes only and does not constitute billing, coding, or reimbursement advice. Nothing on this page should be relied upon as a substitute for clinician assessment, professional billing guidance, or as a definitive statement of any payor's billing requirements or policies.

Payor agreements, fee schedules, and billing policies vary and are subject to change. Before submitting any claims related to maternity care services, including claims affected by the 2027 CPT code revisions, please consult the applicable payor agreements, coverage policies, and billing guidelines to confirm current requirements for their specific payor contracts.

Substrate makes no representation or warranty regarding the accuracy, completeness, or timeliness of the payor-specific information presented here. Providers are solely responsible for ensuring that all claims are submitted in accordance with applicable payor requirements, and Substrate assumes no liability for claim denials, underpayments, or other adverse outcomes arising from reliance on this information.