Talk to Us

Blue Cross and Blue Shield of Montana policies, page 4

Search Blue Cross and Blue Shield of Montana's public medical, payment and drug policies by CPT or HCPCS code, keyword or policy number, with links to the payer's own documents. Links open the payer's own document; check its current version before relying on it.

425 public policies Substrate tracks for Blue Cross and Blue Shield of Montana, by title.

Blue Cross and Blue Shield of Montana policies
PolicyDetailsCodesSource
Gene Therapy for Aromatic L-amino Acid Decarboxylase DeficiencyRX501.178 · Effective Nov 15, 2025 · Commercial, Medicaid3Original policy ↗
Gene Therapy for Inherited Retinal DystrophyRX501.098 · Effective Aug 1, 2026 · Commercial, Medicaid3Original policy ↗
Genicular Artery EmbolizationSUR705.048 · Effective Jul 15, 2025 · Commercial, Medicaid5Original policy ↗
Givosiran for Acute Hepatic PorphyriaRX501.125 · Effective Nov 1, 2025 · Commercial, Medicaid1Original policy ↗
GolimumabRX501.112 · Commercial, Medicaid1Original policy ↗
Gonadotropin-Releasing Hormone (GnRH) Agonists and AntagonistsRX501.041 · Commercial, Medicaid12Original policy ↗
GuselkumabRX501.175 · Commercial, Medicaid1Original policy ↗
Handheld Radiofrequency Spectroscopy for Intraoperative Assessment of Surgical Margins During Breast-Conserving SurgerySUR701.037 · Commercial, Medicaid2Original policy ↗
Heart TransplantSUR703.005 · Commercial, Medicaid4Original policy ↗
Heart/Lung TransplantSUR703.006 · Commercial, Medicaid11Original policy ↗
Heat and Cold Therapy DevicesTHE801.004 · Effective Jan 1, 2026 · Commercial, Medicaid13Original policy ↗
Hematopoietic Cell Transplantation for Acute Lymphoblastic LeukemiaSUR703.043 · Commercial, Medicaid70Original policy ↗
Hematopoietic Cell Transplantation for Acute Myeloid LeukemiaSUR703.037 · Commercial, Medicaid68Original policy ↗
Hematopoietic Cell Transplantation for Autoimmune DiseasesSUR703.036 · Effective Jun 15, 2026 · Commercial, Medicaid69Original policy ↗
Hematopoietic Cell Transplantation for Breast CancerSUR703.038 · Commercial, Medicaid67Original policy ↗
Hematopoietic Cell Transplantation for Central Nervous System Embryonal Tumors and EpendymomaSUR703.039 · Commercial, Medicaid68Original policy ↗
Hematopoietic Cell Transplantation for Chronic Lymphocytic Leukemia (CLL) and Small Lymphocytic Lymphoma (SLL)SUR703.029 · Commercial, Medicaid68Original policy ↗
Hematopoietic Cell Transplantation for Chronic Myeloid LeukemiaSUR703.041 · Commercial, Medicaid67Original policy ↗
Hematopoietic Cell Transplantation for Epithelial Ovarian CancerSUR703.034 · Commercial, Medicaid67Original policy ↗
Hematopoietic Cell Transplantation for Genetic Diseases and Acquired AnemiasSUR703.033 · Commercial, Medicaid67Original policy ↗
Hematopoietic Cell Transplantation for Hodgkin LymphomaSUR703.040 · Effective Apr 15, 2026 · Commercial, Medicaid69Original policy ↗
Hematopoietic Cell Transplantation for Miscellaneous Solid Tumors in AdultsSUR703.035 · Commercial, Medicaid68Original policy ↗
Hematopoietic Cell Transplantation for Non-Hodgkin LymphomasSUR703.031 · Effective May 1, 2026 · Commercial, Medicaid72Original policy ↗
Hematopoietic Cell Transplantation for Plasma Cell Dyscrasias, Including Multiple Myeloma and POEMS SyndromeSUR703.030 · Commercial, Medicaid68Original policy ↗
Hematopoietic Cell Transplantation for Primary Systemic AmyloidosisSUR703.046 · Commercial, Medicaid68Original policy ↗
Hematopoietic Cell Transplantation for Solid Tumors of ChildhoodSUR703.044 · Effective Jun 15, 2026 · Commercial, Medicaid68Original policy ↗
Hematopoietic Cell Transplantation for Waldenstrom MacroglobulinemiaSUR703.050 · Commercial, Medicaid68Original policy ↗
Hematopoietic Cell Transplantation in the Treatment of Germ Cell TumorsSUR703.045 · Commercial, Medicaid70Original policy ↗
High Intensity Laser Therapy for Chronic Musculoskeletal Pain Conditions and Bell’s PalsyMED201.057 · Effective Oct 15, 2025 · Commercial, Medicaid3Original policy ↗
Hip ResurfacingSUR705.019 · Commercial, Medicaid3Original policy ↗
Home Cardiorespiratory MonitoringDME101.020 · Commercial, Medicaid8Original policy ↗
Home Non-Invasive Positive Airway Pressure Devices for the Treatment of Respiratory Insufficiency and FailureMED204.007 · Effective May 15, 2026 · Commercial, Medicaid4Original policy ↗
Hormone Replacement TherapiesRX501.007 · Effective Aug 1, 2026 · Commercial, Medicaid15Original policy ↗
Hospital Beds and Related EquipmentDME101.001 · Commercial, Medicaid58Original policy ↗
Human Growth Hormone (GH)RX501.040 · Effective Jan 1, 2026 · Commercial, Medicaid4Original policy ↗
Hyperbaric Oxygen (HBO2) TherapyTHE801.003 · Effective Jan 1, 2026 · Commercial, Medicaid4Original policy ↗
Hyperthermic Intraperitoneal Chemotherapy for Select Intra-Abdominal and Pelvic MalignanciesSUR701.029 · Commercial, Medicaid10Original policy ↗
Ibalizumab-uiykRX501.099 · Effective Apr 1, 2026 · Commercial, Medicaid1Original policy ↗
Image-Guided Minimally Invasive Decompression for Spinal StenosisSUR712.035 · Commercial, Medicaid3Original policy ↗
Immunoglobulin TherapyRX504.003 · Commercial, Medicaid30Original policy ↗
Implantable Bone-Conduction and Bone-Anchored Hearing AidsSUR714.003 · Effective Jan 1, 2026 · Commercial, Medicaid20Original policy ↗
Implantable Cardioverter DefibrillatorsSUR707.003 · Effective Dec 15, 2025 · Commercial, Medicaid59Original policy ↗
Implantable Peripheral Nerve Stimulation for Chronic Pain ConditionsMED205.042 · Commercial, Medicaid36Original policy ↗
Incident To Billing PolicyN017.2 · Commercial, Medicaid · MT—Original policy ↗
InclisiranRX501.142 · Effective Jan 1, 2026 · Commercial, Medicaid1Original policy ↗
Inebilizumab-cdonRX501.127 · Effective May 1, 2026 · Commercial, Medicaid1Original policy ↗
Infliximab and Associated BiosimilarsRX501.051 · Effective Jan 1, 2026 · Commercial, Medicaid6Original policy ↗
Infrared Therapy DevicesDME101.045 · Commercial, Medicaid3Original policy ↗
Inhaled Nitric OxideTHE801.038 · Commercial, Medicaid1Original policy ↗
Injectable Bulking Agents for the Treatment of Urinary and Fecal IncontinenceSUR710.008 · Commercial, Medicaid6Original policy ↗

Back to Blue Cross and Blue Shield of Montana · Blue Cross and Blue Shield of Montana prior authorization CPT list

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.

This website uses cookies to ensure you get the best experience on our website. Learn more