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Blue Cross and Blue Shield of Texas

BCBS TX

Blue Cross and Blue Shield of Texas logo

Provider portalapps.availity.com ↗

Primary payer ID
Compare transaction IDs ↓
Last successful claim statusWithin the past 48 hoursObserved across Substrate's claim-status network.
SupportedEDI 276/277EDI 270/271Browser automation

Coverage profile

Work Blue Cross and Blue Shield of Texas across every published route

Use the current payer record to choose the right claim-status, eligibility, portal, phone, or appeals workflow. Substrate only marks routes that are published for this payer.

Claim status

EDI 276/277

The Substrate Claim Status Agent can check clearinghouse claim status for your practice with Blue Cross and Blue Shield of Texas.

Available

Eligibility

EDI 270/271

The Substrate Eligibility Agent can verify patient benefits, identify TPAs and carve-outs, and more with Blue Cross and Blue Shield of Texas.

Available

Portal claim status

Browser automation

The Substrate Claim Status Agent can check claim status via the payer portal for Blue Cross and Blue Shield of Texas.

Available

Appeals agent

AI appeals workflow

The Substrate Appeals Agent can submit appeals for RFIs, medical record requests, downcoding reconsiderations, and more via the payer portal for Blue Cross and Blue Shield of Texas.

Available

Other aliases

Also known as

  • 00021
  • 10048
  • 1406
  • 5501
  • 84980
  • CB900
  • DX900
  • G84980
  • HCSVC
  • SB900
  • TXBCBS
  • TXBLS
  • BCBSTX
  • Blue Cross Blue Shield Texas Medicaid STAR CHIP
  • Blue Cross Blue Shield Texas Medicaid STAR Children's Health Insurance Program
  • Blue Cross Blue Shield of Texas
  • Blue Cross and Blue Shield of Texas - Medicare Advantage
  • BlueCross Blue Shield of Texas
  • Bryan Independent School
  • Federal Employee Program Texas (FEP)
  • Health Maintenance Organization Blue
  • Health Maintenance Organization Blue Texas
  • Healthcare Benefits
  • Rio Grande
  • Walmart (BlueCard Carriers)
  • HMO BLUE
  • BCBSTX8498
  • HMO BLUE TEXAS
  • BCBS TEXAS
  • WALMART (BLUE CARD CARRIERS)

BlueCard home-plan routing

These 832 member ID prefixes resolve to Blue Cross and Blue Shield of Texas as their terminal payer. Open a prefix to review its home plan, state, payer ID, and published routes.

Member ID prefixes

Payer intelligence

Observed adjudication timing

How long completed claims in Substrate’s aggregate network took from payer receipt to the 835 payment date.

Median time to payment

3 days
10% of adjudications by
1 day
90% of adjudications by
6 days
Applicable state coverage
TX
Current As Of
August 2026

Five-month median trend

Days to 835 payment
Blue Cross and Blue Shield of Texas median observed adjudication timingMonthly median days from payer receipt to 835 payment from April 2026 through August 2026. Missing qualified months are shown as gaps.0510AprMayJunJulAug
View chart data as a table
Blue Cross and Blue Shield of Texas observed adjudication timing by service month
Service monthMedian10% of adjudications by90% of adjudications byCompleted claimsCoverage
Apr6 days2 days24 days497TX
May5 days2 days12 days2,012TX
Jun4.9 days2 days9.4 days2,649TX
Jul4 days2 days8 days2,565TX
Aug3 days1 day6 days522TX

2027 maternity billing research

When does Blue Cross and Blue Shield of Texas change OB/GYN billing?

Current policy only

RP044 is effective 2026-05-22 and describes current professional-provider maternity reimbursement. It permits global billing for complete care under specified provider/location/TIN conditions and describes separate billing for partial or transferred care. This document does not state a 2027 CPT implementation date or transition rules.

Transition start
Not stated in RP044
Billing start
2026-05-22 (policy effective date)
Published
Not stated in source
Current As Of
August 2026

Scope: BCBSTX professional-provider obstetrical maternity claims. Specific member-product and program applicability is not identified in the document; this is not 2027 implementation guidance.

Open Blue Cross and Blue Shield of Texas in the payer explorer →
View Payer Policy ↗Upstream page ↗

RP044 Global Obstetrical/OB Maternity Services Policy. Verify the payer source before claim submission.

Frequently asked questions

Blue Cross and Blue Shield of Texas payer FAQs

How do I check claim status with Blue Cross and Blue Shield of Texas?

Providers check Blue Cross and Blue Shield of Texas via EDI 276/277 when the payer ID is accepted. Substrate automates claim status across 3,500+ payers.

What is the payer ID for Blue Cross and Blue Shield of Texas?

The primary payer ID for Blue Cross and Blue Shield of Texas is 84980. The correct routing ID can differ by clearinghouse and transaction, so compare the 837P, 837I, 835, 270, and 276 entries before submitting.

What is the provider portal for Blue Cross and Blue Shield of Texas?

The provider portal for Blue Cross and Blue Shield of Texas is https://apps.availity.com/. Available features depend on the payer and your account.

What are the 837 payer IDs for Blue Cross and Blue Shield of Texas?

The 837P and 837I payer ID for Blue Cross and Blue Shield of Texas is 84980 via Stedi.

What is the 835 payer ID for Blue Cross and Blue Shield of Texas?

The 835 payer ID for Blue Cross and Blue Shield of Texas is 84980 via Stedi.

What is the 270 payer ID for Blue Cross and Blue Shield of Texas?

The 270 payer IDs for Blue Cross and Blue Shield of Texas are 84980 via Stedi and G84980 via Availity.

What is the 276 payer ID for Blue Cross and Blue Shield of Texas?

The 276 payer IDs for Blue Cross and Blue Shield of Texas are 84980 via Stedi and G84980 via Availity.

What states does Blue Cross and Blue Shield of Texas operate in?

Blue Cross and Blue Shield of Texas operates in CT, IL, NM, TX, and UT.

Resource library

Routing reference

Blue Cross and Blue Shield of Texas payer IDs and operating states

Use the payer ID listed for the transaction you are submitting. Verify current routing and enrollment requirements with your clearinghouse.

Blue Cross and Blue Shield of Texas payer name, operating states, and transaction-specific payer IDs
Payer nameBlue Cross and Blue Shield of TexasSource: Substrate payer directory · last refreshed
Operating statesCT, IL, NM, TX, UTSource: Substrate payer directory · last refreshed
837P professional claims payer IDStedi84980Source: Stedi payer catalog · catalog dated · matched by payer ID
837I institutional claims payer IDStedi84980Source: Stedi payer catalog · catalog dated · matched by payer ID
835 ERA payer IDStedi84980Enrollment requiredSource: Stedi payer catalog · catalog dated · matched by payer ID
270 eligibility payer IDStedi84980Source: Stedi payer catalog · catalog dated · matched by payer ID
270 eligibility payer IDAvailityG84980Source: Availity payer catalog · catalog dated · matched by payer name
276 claim status payer IDStedi84980Source: Stedi payer catalog · catalog dated · matched by payer ID
276 claim status payer IDAvailityG84980Source: Availity payer catalog · catalog dated · matched by payer name

Routing sources and verification

  • Substrate payer directoryPayer identity, aliases, operating states, and vendor IDs. Last refreshed .Open payer website ↗
  • Stedi payer catalogMatched by payer ID; matched record: Blue Cross and Blue Shield of Texas. Source dated .PrimaryPayerId is used as the transaction payer ID when the corresponding Stedi support flag is true.Open current Stedi reference ↗
  • Availity payer catalogMatched by payer name; matched record: BCBS TEXAS. Source dated .The attached API workbook supplies 270 and 276 payer IDs only. It does not supply 837P, 837I, or 835 IDs.Open current Availity reference ↗
  • United Clearinghouse payer catalogMatched by payer name; matched record: Blue Cross and Blue Shield of Texas. The source did not provide a publication date.The attachment supplies payer names and states only; it does not contain transaction-specific payer IDs.Open current United Clearinghouse reference ↗

Clearinghouse payer IDs are transaction-specific and can change. Confirm the current payer list and the member’s ID card before submission.

Payer contact directory

Blue Cross and Blue Shield of Texas phone and fax numbers

Use the number associated with your task. These contacts were stated in successful eligibility responses and may apply to specific benefits, products, or departments.

Eligibility / benefits phone
(800) 676-2583BLUE CROSS AND BLUE SHIELD OF TEXAS
Payer fax
(888) 282-1321BLUE CROSS AND BLUE SHIELD OF TEXAS
Blue Cross and Blue Shield of Texas payer phone and fax directory
Channel and numberPayer NotesDepartmentSpecialties
fax(866) 411-2573Prior authorizationBenefit context: Co-Insurance
  • ACUTE INPATIENT REHABILITATION ADMISSION PRECERTIFICATION
  • SKILLED NURSING FACILITY ADMISSION PRECERTIFICATION
Hospital
fax(866) 411-2585Prior authorizationBenefit context: Co-Insurance
  • ACUTE INPATIENT HOSPITAL ADMISSION PRECERTIFICATION
Hospital
fax(410) 781-7661Utilization managementBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • UTILIZATION MANAGEMENT
fax(866) 606-6021Other stated context, PharmacyBenefit context: Active Coverage; Benefit context: Coverage Basis
  • PA LOGIC SOLUTIONS
Pharmacy
fax(323) 889-2100Other stated contextBenefit context: Co-Payment
  • BLUE SHIELD OF CALIFORNIA PROMISE HEALTH PLAN
Hospital
fax(800) 348-3804Other stated contextBenefit context: Co-Insurance
  • BCBS OF MISSISSIPPI
Hospital
fax(800) 453-4341Other stated contextBenefit context: Co-Insurance; Benefit context: Co-Payment
  • CLINICAL INTAKE OPERATIONS
Hospital
fax(833) 453-0101Other stated contextBenefit context: Coverage Basis
  • REACH KIDNEY CARE
fax(833) 938-9934Other stated contextBenefit context: Co-Insurance; Benefit context: Deductible
  • CREDENCE BCBS
Hospital
fax(844) 295-4637Other stated contextBenefit context: Co-Insurance; Benefit context: Co-Payment
  • BLUE SHIELD OF CALIFORNIA
Hospital
fax(844) 696-0975Other stated contextBenefit context: Co-Insurance; Benefit context: Co-Payment
  • BLUE SHIELD OF CALIFORNIA
Hospital
fax(877) 663-7526Other stated contextBenefit context: Co-Payment
  • CLINICAL INTAKE OPERATIONS
Hospital
fax(877) 665-5542Other stated contextBenefit context: Limitations
  • AMERICAN HEALTH HOLDING
Hospital, Hospital - Inpatient
fax(888) 656-6671Other stated contextBenefit context: Coverage Basis
  • PRIME THERAPEUTICS
fax(501) 378-2562
  • ARKANSAS BLUE CROSS BLUE SHIELD
fax(501) 378-2965
  • BLUEADVANTAGE ADMINISTRATORS OF ARK
fax(501) 379-1200
  • SKAI BLUE CROSS BLUE SHIELD
fax(888) 282-1321
  • BLUE CROSS AND BLUE SHIELD OF TEXAS
phone(800) 237-6060Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • DELTA DENTAL
Dental Care
phone(800) 244-6224Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • CIGNA
Dental Care
phone(800) 322-6384Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • DENTI-CAL
Dental Care
phone(800) 334-7591Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • EYEMED
Vision (Optometry)
phone(800) 334-8134Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • RX BENEFITS CVS CAREMARK
Pharmacy
phone(800) 335-8266Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • DELTA DENTAL OF MO
Dental Care
phone(800) 349-3780Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • EXPRESS SCRIPTS
Pharmacy
phone(800) 356-3477Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • OPTUMRX
Pharmacy
phone(800) 364-6331Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • CVS CAREMARK
  • CVS/CAREMARK
Pharmacy
phone(800) 421-5501Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • CVS CAREMARK
Pharmacy
phone(800) 441-9188Eligibility / benefits, Other stated contextBenefit context: Co-Payment; Benefit context: Contact Following Entity for Eligibility or Benefit Information
  • BCBSTX
  • Customer Service
Health Benefit Plan Coverage, Health Benefit Plan Coverage, Hospital - Emergency Accident, Urgent Care, Hospital - Emergency Medical, Chiropractic, Professional (Physician) Visit - Office, Physician Visit - Office: Well, Health Benefit Plan Coverage, Hospital, Hospital - Inpatient, Hospital - Emergency Accident, Urgent Care, Hospital - Emergency Medical, Emergency Services, Chiropractic, Professional (Physician) Visit - Office, Physician Visit - Office: Well, Hospital - Outpatient, Hospital, Hospital - Inpatient, Urgent Care, Chiropractic, Professional (Physician) Visit - Office, Physician Visit - Office: Well, Urgent Care, Professional (Physician) Visit - Office
phone(800) 451-0287Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • BCBSTX
  • CUSTOMER SERVICE
  • Customer Service
Chiropractic, Health Benefit Plan Coverage, Health Benefit Plan Coverage, Hospital - Emergency Accident, Urgent Care, Hospital - Emergency Medical, Chiropractic, Professional (Physician) Visit - Office, Health Benefit Plan Coverage, Hospital - Emergency Accident, Urgent Care, Hospital - Emergency Medical, Chiropractic, Professional (Physician) Visit - Office, Physician Visit - Office: Well, Health Benefit Plan Coverage, Hospital, Hospital - Inpatient, Hospital - Emergency Accident, Urgent Care, Hospital - Emergency Medical, Emergency Services, Chiropractic, Professional (Physician) Visit - Office, Physician Visit - Office: Well, Hospital - Outpatient, Health Benefit Plan Coverage, Hospital, Hospital - Inpatient, Hospital - Emergency Accident, Urgent Care, Hospital - Emergency Medical, Emergency Services, Chiropractic, Professional (Physician) Visit - Office, Physician Visit - Office: Well, Hospital - Outpatient, Vision (Optometry), Hospital, Hospital - Inpatient, Physician Visit - Office: Well, Urgent Care, Chiropractic, Professional (Physician) Visit - Office, Physician Visit - Office: Well, Vision (Optometry), Urgent Care, Chiropractic, Professional (Physician) Visit - Office, Vision (Optometry), Vision (Optometry)
phone(800) 507-3800Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • Superior Vision
Vision (Optometry)
phone(800) 508-6785Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • DENTAQUEST
Dental Care
phone(800) 521-2651Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • DELTA DENTAL
Dental Care
phone(800) 523-4702Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • National Elevator Industry Health Benefit Plan
Physician Visit - Office: Well
phone(800) 524-0149Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • DELTA DENTAL
Dental Care
phone(800) 610-0201Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • DELTA DENTAL OF CO
Dental Care
phone(800) 627-4200Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • GUARDIAN
Dental Care
phone(800) 638-3120Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • United Health Care
Vision (Optometry)
phone(800) 638-3895Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • Spectera
Vision (Optometry)
phone(800) 676-2583Eligibility / benefits, Other stated contextBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Limitations; Benefit context: Active Coverage
  • ARKANSAS BLUE CROSS BLUE SHIELD
  • BCBS OF MISSISSIPPI
  • BCBSTX
  • BLUE CARD ELIGIBILITY
  • BLUE CARE NETWORK
  • BLUE CROSS AND BLUE SHIELD OF TEXAS
  • BLUE CROSS OF MICHIGAN
  • BLUEADVANTAGE ADMINISTRATORS OF ARK
  • CAPITAL BLUE CROSS
  • Customer Service
  • G84980
Health Benefit Plan Coverage, Hospital, Physician Visit - Office: Well, Urgent Care, Professional (Physician) Visit - Office
phone(800) 710-9341Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • LIVINITI
Pharmacy
phone(800) 765-6003Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • DELTA
  • DELTA DENTAL OF CA
Dental Care
phone(800) 789-7488Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • ESI
Pharmacy
phone(800) 800-7153Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • OPTUM/CORETRUST
Pharmacy
phone(800) 831-4914Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • SOUTHERN BENEFIT ADMINISTRATORS
Dental Care
phone(800) 854-7771Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • MEDI-CAL LA CARE BHA
Mental Health
phone(800) 868-1032Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • COMPANION BENEFIT ALTERNATIVES
Mental Health
phone(800) 877-7195Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • VSP
  • VSP VISION CARE
Vision (Optometry)
phone(800) 923-6766Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • Superior Vision
Vision (Optometry)
phone(800) 942-0854Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • METLIFE
  • METLIFE DENTAL
Dental Care
phone(800) 955-2030Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • DELTA DENTAL OF KY
Dental Care
phone(800) 972-8088Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • CUSTOMER SERVICE
  • Customer Service
Hospital, Hospital - Inpatient, Hospital, Hospital - Inpatient, Physician Visit - Office: Well, Physician Visit - Office: Well
phone(800) 977-2273Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • MAGELLAN
Pharmacy
phone(800) 981-3546Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • Customer Service
Hospital, Hospital - Inpatient
phone(800) 999-5431Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • DAVIS VISION
  • Davis Vision
Vision (Optometry)
phone(833) 485-6238Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • CARELONRX
Pharmacy
phone(833) 783-1448Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • RIGHTWAY RX
Pharmacy
phone(844) 260-5889Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • CVS CAREMARK
Pharmacy
phone(844) 354-3241Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • CVS/CAREMARK
Pharmacy
phone(844) 402-5347Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • ANTHEM DENTAL ESSENTIAL CHOICE
Dental Care
phone(844) 454-5201Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • SMITH RX
Pharmacy
phone(844) 550-2712Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • EXPRESS SCRIPTS MEDCO
Pharmacy
phone(844) 714-5678Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • EyeMed
Vision (Optometry)
phone(844) 770-1500Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • Davis Vision
Vision (Optometry)
phone(855) 295-9140Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • OPTIUM
Pharmacy
phone(855) 524-0381Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • OPTUMRX
Pharmacy
phone(855) 558-1439Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • BLUE VIEW VISION
Vision (Optometry)
phone(855) 690-7796Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • BLUE VIEW VISION
Vision (Optometry)
phone(855) 702-6262Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • MCNA DENTAL
Dental Care
phone(855) 811-2218Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • OPTUMRX
Pharmacy
phone(855) 845-5441Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • Blue Cross Blue Shield Illinois
phone(855) 862-4300Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • EyeMed
Vision (Optometry)
phone(866) 299-1358Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • EyeMed
Vision (Optometry)
phone(866) 312-3077Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • UNITED BEHAVIORAL HEALTH
Pharmacy
phone(866) 723-0513Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • EyeMed
Vision (Optometry)
phone(866) 776-4793Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • ANTHEM BEHAVIORAL HEALTH
Dental Care
phone(866) 797-9884Eligibility / benefits, Utilization managementBenefit context: Contact Following Entity for Eligibility or Benefit Information; Benefit context: Co-Payment
  • CARELONRX
  • UTILIZATION MANAGEMENT
Chiropractic, Pharmacy
phone(866) 800-5457Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • EyeMed
Vision (Optometry)
phone(866) 819-4298Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • SUPERIOR VISION
Vision (Optometry)
phone(877) 207-1357Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • EXPRESS SCRIPTS (ESI)
Pharmacy
phone(877) 393-2393Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • Davis Vision
Vision (Optometry)
phone(888) 202-1654Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • CVS CAREMARK (CVS)
Pharmacy
phone(888) 234-5181Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • Davis Vision
Vision (Optometry)
phone(888) 265-7790Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • CVS Specialty RX
Professional (Physician) Visit - Office
phone(888) 349-3706Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • CUSTOMER SERVICE
Hospital - Emergency Accident, Hospital - Emergency Medical, Hospital, Hospital - Inpatient
phone(888) 352-7924Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • LIBERTY DENTAL
Dental Care
phone(888) 359-1086Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • LIBERTY DENTAL
Dental Care
phone(888) 700-0992Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • LIBERTY DENTAL
Dental Care
phone(888) 826-8152Eligibility / benefitsBenefit context: Contact Following Entity for Eligibility or Benefit Information
  • DENTAL NETWORK OF AMERICA
Dental Care
phone(800) 274-7767Other stated context, Utilization managementBenefit context: Co-Insurance; Benefit context: Co-Payment
  • ANTHEM BLUE CROSS OF CALIFORNIA
  • UTILIZATION MANAGEMENT
Hospital, Hospital, Hospital - Inpatient, Hospital - Outpatient
phone(800) 336-7767Utilization managementBenefit context: Co-Insurance
  • UTILIZATION MANAGEMENT
Hospital
phone(800) 832-7850Utilization managementBenefit context: Co-Insurance
  • UTILIZATION MANAGEMENT
Hospital
phone(818) 702-0100Utilization managementBenefit context: Co-Insurance
  • UTILIZATION MANAGEMENT
Professional (Physician) Visit - Office
phone(844) 521-6942Utilization managementBenefit context: Co-Payment
  • UTILIZATION MANAGEMENT
Chiropractic, Physician Visit - Office: Well
phone(855) 260-7770Utilization managementBenefit context: Co-Insurance
  • UTILIZATION MANAGEMENT
Hospital
phone(855) 343-4851Other stated context, Utilization managementBenefit context: Co-Insurance; Benefit context: Co-Payment
  • ANTHEM BLUE CROSS AND BLUE SHIELD
  • UTILIZATION MANAGEMENT
Hospital, Hospital, Hospital - Inpatient, Hospital - Outpatient
phone(855) 629-3650Utilization managementBenefit context: Co-Insurance
  • UTILIZATION MANAGEMENT
Hospital
phone(855) 671-2667Utilization managementBenefit context: Co-Insurance
  • UTILIZATION MANAGEMENT
Hospital, Hospital - Inpatient, Hospital - Outpatient
phone(866) 470-6244Utilization managementBenefit context: Co-Insurance; Benefit context: Co-Payment
  • UTILIZATION MANAGEMENT
Hospital
phone(866) 773-2884Other stated context, Utilization managementBenefit context: Co-Insurance; Benefit context: Contact Following Entity for Eligibility or Benefit Information
  • Pre Service Review
  • UTILIZATION MANAGEMENT
Hospital - Inpatient
phone(866) 898-9354Utilization managementBenefit context: Co-Insurance
  • UTILIZATION MANAGEMENT
Hospital
phone(877) 284-0102Utilization managementBenefit context: Co-Insurance
  • UTILIZATION MANAGEMENT
Hospital
phone(888) 779-7247Utilization managementBenefit context: Co-Insurance
  • UTILIZATION MANAGEMENT
Chiropractic
phone(800) 924-7141Other stated context, PharmacyBenefit context: Co-Insurance; Benefit context: Benefit Description
  • BLUECROSS AND BLUESHIELD OF TENNESSEE
  • MAGELLANRX
Hospital - Outpatient, Pharmacy
phone(866) 205-5107Other stated context, PharmacyBenefit context: Active Coverage; Benefit context: Coverage Basis
  • PA LOGIC SOLUTIONS
Pharmacy
phone(866) 325-1794PharmacyBenefit context: Benefit Description
  • OPTUM RX
Pharmacy
phone(866) 688-2242PharmacyBenefit context: Active Coverage
  • PRIME THERAPEUTICS
Pharmacy
phone(205) 879-1150Behavioral healthBenefit context: Non-Covered
  • BEHAVIORAL HEALTH SYSTEMS MANAGED CARE PROGRAM
Mental Health
phone(800) 245-1150Behavioral healthBenefit context: Non-Covered
  • BEHAVIORAL HEALTH SERVICES
  • BEHAVIORAL HEALTH SYSTEMS
  • BHS
Mental Health
phone(802) 245-1150Behavioral healthBenefit context: Non-Covered
  • BHS
Mental Health
phone(855) 339-8558Behavioral health, Other stated contextBenefit context: Active Coverage; Benefit context: Coverage Basis
  • LUCET
Mental Health
phone(866) 322-1657Behavioral healthBenefit context: Active Coverage
  • BEHAVIORAL HEALTH MANAGER
Mental Health
phone(602) 864-4320Other stated contextBenefit context: Benefit Description
  • BLUE CROSS BLUE SHIELD OF AZ
Hospital - Inpatient, Professional (Physician) Visit - Office, Hospital, Hospital - Outpatient
phone(602) 864-4400Other stated contextBenefit context: Benefit Description
  • BLUE CROSS BLUE SHIELD OF AZ
Health Benefit Plan Coverage
phone(800) 232-2345Other stated contextBenefit context: Benefit Description
  • BLUE CROSS BLUE SHIELD OF AZ
Health Benefit Plan Coverage, Hospital - Inpatient, Professional (Physician) Visit - Office, Hospital, Hospital - Outpatient
phone(800) 248-2342Other stated contextBenefit context: Co-Insurance; Benefit context: Deductible
  • BCBS OF ALABAMA
Hospital
phone(800) 275-2583Other stated contextBenefit context: Co-Insurance; Benefit context: Limitations
  • AUTHORIZATIONS
Hospital - Inpatient, Hospital, Physician Visit - Office: Well
phone(800) 351-2370Other stated contextBenefit context: Co-Insurance; Benefit context: Co-Payment
  • CLINICAL INTAKE OPERATIONS
Hospital
phone(800) 397-7337Other stated contextBenefit context: Co-Insurance; Benefit context: Co-Payment; Benefit context: Deductible
  • Availity Auth and Referrals Page
Hospital - Inpatient, Hospital - Outpatient
phone(800) 424-8270Other stated contextBenefit context: Coverage Basis
  • PRIME THERAPEUTICS
phone(800) 452-8507Other stated contextBenefit context: Active Coverage
  • HIGHMARK MEDICAL MANAGEMENT & POLICY
Hospital
phone(800) 476-0677Other stated contextBenefit context: Non-Covered
  • SOUTHLAND NATIONAL INSURANCE CORP
Vision (Optometry)
phone(800) 480-6658Other stated contextBenefit context: Active Coverage
  • MEDICAL MANAGEMENT & POLICY
Hospital
phone(800) 523-6435Other stated contextBenefit context: Co-Payment
  • LABLUE Clinical Inquiry
Chiropractic, Hospital - Emergency Accident, Hospital - Emergency Medical, Emergency Services
phone(800) 541-6652Other stated contextBenefit context: Co-Insurance; Benefit context: Co-Payment
  • BLUE SHIELD OF CALIFORNIA
Hospital
phone(800) 572-2872Other stated contextBenefit context: Active Coverage
  • BCBSDE MANAGED CARE
Hospital
phone(800) 605-2556Other stated contextBenefit context: Co-Payment
  • BLUE SHIELD OF CALIFORNIA PROMISE HEALTH PLAN
Hospital
phone(800) 664-2583Other stated contextBenefit context: Active Coverage
  • HORIZON BCBSNJ
Health Benefit Plan Coverage
phone(800) 678-9133Other stated contextBenefit context: Benefit Description
  • ASH - AMERICAN SPECIALTY HEALTH NETWORK
Chiropractic
phone(800) 780-7881Other stated contextBenefit context: Co-Insurance; Benefit context: Co-Payment
  • CLINICAL INTAKE OPERATIONS
Hospital
phone(800) 786-7474Other stated contextBenefit context: Co-Insurance; Benefit context: Co-Payment
  • BLUE SHIELD OF CALIFORNIA
Hospital
phone(800) 827-4814Other stated contextBenefit context: Limitations
  • BLUEADVANTAGE ADMINISTRATORS OF ARKANSAS
  • SKAI BLUE CROSS AND BLUE SHIELD
Hospital - Inpatient, Hospital - Inpatient, Hospital - Outpatient, Hospital, Hospital - Inpatient
phone(800) 841-9659Other stated contextBenefit context: Co-Insurance
  • BCBS OF MISSISSIPPI
Hospital
phone(800) 842-5252Other stated contextBenefit context: Other or Additional Payor
  • UNITED HEALTHCARE
Health Benefit Plan Coverage
phone(800) 920-2485Other stated contextBenefit context: Active Coverage
  • EXCELLUS BLUE CROSS BLUE SHIELD
Health Benefit Plan Coverage
phone(800) 922-8778Other stated contextBenefit context: Co-Insurance
  • INTEGRATED HEALTH MANAGEMENT
Hospital
phone(800) 972-4226Other stated contextBenefit context: Benefit Description; Benefit context: Co-Insurance
  • ASH - AMERICAN SPECIALTY HEALTH NETWORK
  • American Specialty Health (ASH)
Chiropractic, Hospital - Outpatient
phone(833) 424-7770Other stated contextBenefit context: Co-Payment
  • AHA
Hospital
phone(833) 447-4397Other stated contextBenefit context: Coverage Basis
  • REACH KIDNEY CARE
phone(833) 462-0104Other stated contextBenefit context: Limitations
  • AMERICAN HEALTH HOLDING
Hospital, Hospital - Inpatient
phone(833) 462-0112Other stated contextBenefit context: Co-Insurance
  • AHH
Hospital, Hospital - Inpatient
phone(833) 578-4436Other stated contextBenefit context: Co-Insurance
  • ANTHEM BLUE CROSS AND BLUE SHIELD
Hospital, Urgent Care
phone(833) 578-4441Other stated contextBenefit context: Co-Insurance
  • ANTHEM BLUE CROSS AND BLUE SHIELD
Hospital, Hospital - Inpatient
phone(833) 592-9954Other stated contextBenefit context: Co-Insurance
  • ANTHEM BLUE CROSS AND BLUE SHIELD
Hospital
phone(833) 592-9956Other stated contextBenefit context: Co-Insurance
  • ANTHEM BLUE CROSS AND BLUE SHIELD
Hospital, Hospital, Hospital - Inpatient
phone(833) 639-1634Other stated contextBenefit context: Co-Insurance
  • ANTHEM BLUE CROSS AND BLUE SHIELD
Hospital, Hospital - Inpatient
phone(833) 639-1638Other stated contextBenefit context: Co-Insurance
  • ANTHEM BLUE CROSS AND BLUE SHIELD
Hospital, Hospital - Inpatient
phone(833) 663-8703Other stated contextBenefit context: Co-Insurance; Benefit context: Deductible; Benefit context: Coverage Basis
  • CREDENCE BCBS
  • PA LOGIC SOLUTIONS
Hospital
phone(833) 772-4122Other stated contextBenefit context: Co-Insurance
  • ANTHEM BLUE CROSS AND BLUE SHIELD
Hospital
phone(833) 798-6733Other stated contextBenefit context: Coverage Basis
  • BCBSAL
phone(833) 800-4032Other stated contextBenefit context: Coverage Basis
  • BCBSAL
phone(833) 800-4033Other stated contextBenefit context: Coverage Basis
  • BCBSAL
  • CREDENCE BCBS
phone(844) 235-4454Other stated contextBenefit context: Co-Payment
  • EMPIRE MEDICAL MANAGEMENT
Chiropractic
phone(844) 241-7087Other stated contextBenefit context: Co-Insurance; Benefit context: Co-Payment
  • ANTHEM BLUE CROSS AND BLUE SHIELD
Chiropractic, Hospital
phone(855) 243-3326Other stated contextBenefit context: Co-Insurance; Benefit context: Deductible
  • Sleep Management Solutions
Hospital - Inpatient
phone(855) 288-8356Other stated contextBenefit context: Coverage Basis
  • CARELON MEDICAL BENEFITS MANAGEMENT
phone(855) 333-5730Other stated contextBenefit context: Co-Insurance
  • ANTHEM BLUE CROSS OF CALIFORNIA
Hospital, Hospital, Hospital - Inpatient
phone(855) 845-5440Other stated contextBenefit context: Co-Insurance
  • Luminare Health
Hospital, Hospital - Inpatient
phone(866) 678-8079Other stated contextBenefit context: Co-Insurance
  • Quantum
Hospital, Hospital - Inpatient
phone(866) 678-9366Other stated contextBenefit context: Co-Insurance
  • Quantum
Hospital, Hospital - Inpatient
phone(866) 714-1103Other stated contextBenefit context: Co-Insurance
  • CARELON
Hospital
phone(866) 803-8002Other stated contextBenefit context: Coverage Basis
  • CARELON MEDICAL BENEFITS MANAGEMENT
  • EVICORE HEALTHCARE
phone(866) 939-3633Other stated contextBenefit context: Non-Covered
  • EYEMED
Vision (Optometry)
phone(866) 952-0353Other stated contextBenefit context: Deductible
  • QUANTUM HEALTH
Hospital
phone(877) 288-0719Other stated contextBenefit context: Coverage Basis
  • HEALTH EQUITY
phone(877) 291-0360Other stated contextBenefit context: Co-Insurance
  • CARELON
Hospital
phone(877) 291-0366Other stated contextBenefit context: Co-Insurance; Benefit context: Co-Payment
  • CARELON
Chiropractic, Hospital
phone(877) 324-2990Other stated contextBenefit context: Co-Insurance
  • QUANTUM HEALTH
Hospital
phone(877) 811-3106Other stated contextBenefit context: Co-Insurance
  • ANTHEM BLUE CROSS AND BLUE SHIELD
Hospital, Hospital - Inpatient
phone(877) 986-8136Other stated contextBenefit context: Co-Insurance
  • QUANTUM HEALTH
Hospital - Outpatient
phone(888) 312-5713Other stated contextBenefit context: Co-Payment
  • BLUE CROSS COMPLETE
Medical Care
phone(888) 849-3682Other stated contextBenefit context: Co-Payment
  • CLINICAL INTAKE OPERATIONS
Hospital
phone(888) 949-2352Other stated contextBenefit context: Co-Insurance
  • PATRIUS HEALTH
Hospital
phone(888) 953-6703Other stated contextBenefit context: Co-Insurance
  • CARELON
Hospital
phone(888) 986-8588Other stated contextBenefit context: Co-Insurance
  • Quantum Health
Hospital, Hospital - Inpatient
phone(800) 214-4844
  • BLUE CROSS AND BLUE SHIELD OF TEXAS
phone(800) 327-6716
  • BLUE CROSS AND BLUE SHIELD OF TEXAS
phone(800) 432-3990
  • BLUE CROSS AND BLUE SHIELD OF TEXAS
phone(800) 716-2299
  • BLUE CROSS AND BLUE SHIELD OF TEXAS
phone(800) 727-2227
  • BLUE CROSS AND BLUE SHIELD OF TEXAS
phone(844) 465-5227
  • SKAI BLUE CROSS BLUE SHIELD
phone(877) 444-2374
  • BCBS OF NEBRASKA
  • BLUE CROSS AND BLUE SHIELD OF TEXAS
phone(888) 233-8351
  • BCBS OF NEBRASKA
  • BLUE CROSS AND BLUE SHIELD OF TEXAS

Phone and fax numbers sourced directly from the payer response

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 — providers should 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.

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