Blue Cross and Blue Shield of Montana policies, page 9

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
Treatment of Tarlov CystsSUR705.050 · Commercial, Medicaid18Original policy ↗
Treatment of TinnitusMED205.022 · Effective Aug 1, 2026 · Commercial, Medicaid7Original policy ↗
Triamcinolone acetonideOTH903.035 · Commercial, Medicaid3Original policy ↗
Tumor Treating Fields (TTF) TherapyMED201.039 · Commercial, Medicaid3Original policy ↗
Ublituximab-xiiyRX501.153 · Commercial, Medicaid1Original policy ↗
Ultrafiltration in Decompensated Heart FailureMED202.062 · Commercial, Medicaid1Original policy ↗
Ultrasonic Osteogenesis StimulatorDME101.030 · Commercial, Medicaid2Original policy ↗
Unicondylar Interpositional Spacer as a Treatment of Unicompartmental Arthritis of the KneeSUR705.024 · Effective Apr 1, 2026 · Commercial, Medicaid3Original policy ↗
Use of a Medial Knee Implantable Shock AbsorberSUR705.051 · Commercial, Medicaid3Original policy ↗
Ustekinumab and Associated BiosimilarsRX501.114 · Effective Jul 1, 2026 · Commercial, Medicaid15Original policy ↗
Uterus Transplantation for Absolute Uterine Factor InfertilityOB402.035 · Effective May 1, 2026 · Commercial, Medicaid7Original policy ↗
Vagus Nerve Stimulation (VNS)SUR712.021 · Effective Aug 15, 2026 · Commercial, Medicaid29Original policy ↗
Valoctocogene Roxaparvovec-rvoxRX501.128 · Effective Jan 1, 2026 · Commercial, Medicaid1Original policy ↗
Varicose Vein ManagementSUR707.016 · Commercial, Medicaid27Original policy ↗
VedolizumabRX501.117 · Commercial, Medicaid1Original policy ↗
Ventricular Assist Devices and Total Artificial HeartsSUR707.017 · Commercial, Medicaid52Original policy ↗
Vertebral Axial DecompressionTHE803.021 · Effective Sep 15, 2026 · Commercial, Medicaid3Original policy ↗
Vertical Expandable Prosthetic Titanium RibSUR705.025 · Commercial, Medicaid1Original policy ↗
Vestibular Function TestingMED201.047 · Commercial, Medicaid13Original policy ↗
Viscocanalostomy and CanaloplastySUR713.032 · Commercial, Medicaid3Original policy ↗
Vutrisiran (Amvuttra) and Patisiran (Onpattro)RX501.146 · Effective Jan 1, 2026 · Commercial, Medicaid2Original policy ↗
Wheelchairs and AccessoriesDME101.010 · Effective Jan 1, 2026 · Commercial, Medicaid366Original policy ↗
WilateRX501.160 · Commercial, Medicaid1Original policy ↗
Wireless Capsule Endoscopy for Gastrointestinal (GI) DisordersRAD601.042 · Effective Aug 1, 2026 · Commercial, Medicaid5Original policy ↗
Zopapogene imadenovec-drbaRX501.183 · Commercial, Medicaid2Original policy ↗

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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.

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