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Blue Cross and Blue Shield of Texas policies, page 8

Search Blue Cross and Blue Shield of Texas'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.

543 public policies Substrate tracks for Blue Cross and Blue Shield of Texas, by title.

Blue Cross and Blue Shield of Texas policies
PolicyDetailsCodesSource
Onasemnogene abeparvovec-xioiRX501.104 · Effective Jan 1, 2026 · Commercial, Medicaid2Original policy ↗
Oncologic Applications of Photodynamic Therapy, Including Barrett EsophagusTHE801.029 · Commercial, Medicaid5Original policy ↗
Oncology MedicationsRX502.061 · Effective Jul 1, 2026 · Commercial, Medicaid175Original policy ↗
Onychomycosis TestingRPLAB068 · Effective Sep 4, 2026 · Commercial, Medicaid · TX16Original policy ↗
Ophthalmologic Techniques That Evaluate the Posterior Segment for GlaucomaOTH903.022 · Effective Jan 1, 2026 · Commercial, Medicaid3Original policy ↗
Optical Coherence Tomography of the Anterior Eye SegmentOTH903.021 · Commercial, Medicaid1Original policy ↗
Oral Cancer Screening and TestingCPCPLAB032 · Effective Jan 3, 2026 · Commercial, Medicaid · TX10Original policy ↗
Oral Cancer Screening and TestingRPLAB032 · Effective Dec 4, 2026 · Commercial, Medicaid · TX10Original policy ↗
Organ and Tissue Transplantation (General Donor and Recipient Information)SUR703.001 · Effective Jan 1, 2026 · Commercial, Medicaid3Original policy ↗
Orthognathic SurgerySUR705.030 · Commercial, Medicaid32Original policy ↗
Orthopedic Applications of Platelet-Rich PlasmaRX501.101 · Effective Sep 1, 2026 · Commercial, Medicaid4Original policy ↗
Orthopedic Applications of Stem Cell Therapy (Including Allografts and Bone Substitutes Used with Autologous Bone Marrow)SUR703.051 · Commercial, Medicaid11Original policy ↗
Outpatient Facility Service(s) Overlapping During an Inpatient StayRP039 · Effective Jun 8, 2026 · Commercial, Medicaid · TX—Original policy ↗
Outpatient Pulmonary RehabilitationTHE803.025 · Effective Sep 15, 2026 · Commercial, Medicaid12Original policy ↗
Outpatient Services Prior to Inpatient AdmissionRP038 · Effective May 22, 2026 · Commercial, Medicaid · TX—Original policy ↗
Pancreatic Enzyme Testing for Acute PancreatitisRPLAB047 · Effective Sep 4, 2026 · Commercial, Medicaid · TX8Original policy ↗
Parathyroid Hormone, Phosphorus, Calcium, and Magnesium TestingRPLAB055 · Effective Sep 4, 2026 · Commercial, Medicaid · TX7Original policy ↗
Paravertebral Facet Injection Procedure Billing  & Coding PolicyCPCP036 · Effective Nov 21, 2025 · Commercial, Medicaid · TX16Original policy ↗
Pathogen Panel TestingCPCPLAB045 · Effective Apr 24, 2026 · Commercial, Medicaid · TX67Original policy ↗
Pathogen Panel TestingRPLAB045 · Effective Dec 4, 2026 · Commercial, Medicaid · TX67Original policy ↗
Patient-Specific Instrumentation (e.g., Cutting Guides) for Joint ArthroplastySUR705.037 · Effective Sep 1, 2026 · Commercial, Medicaid2Original policy ↗
Pediatric Preventive ScreeningRPLAB016 · Effective Sep 4, 2026 · Commercial, Medicaid · TX22Original policy ↗
PegloticaseRX501.120 · Commercial, Medicaid1Original policy ↗
Pelvic Floor Stimulation as a Treatment of Urinary or Fecal IncontinenceDME101.037 · Commercial, Medicaid5Original policy ↗
Percutaneous Electrical Nerve Field Stimulation for Irritable Bowel SyndromeMED201.055 · Commercial, Medicaid2Original policy ↗
Percutaneous Electrical Nerve Stimulation, Percutaneous Neuromodulation Therapy, and Restorative Neurostimulation TherapyMED205.032 · Effective Oct 15, 2025 · Commercial, Medicaid4Original policy ↗
Percutaneous Intradiscal Electrothermal Annuloplasty, Radiofrequency Annuloplasty, and BiacuplastySUR712.023 · Commercial, Medicaid2Original policy ↗
Percutaneous Left Atrial Appendage Closure Devices for Stroke Prevention in Atrial FibrillationSUR701.009 · Effective Jul 15, 2025 · Commercial, Medicaid2Original policy ↗
Percutaneous Revascularization Procedures for Lower Extremity Peripheral Arterial DiseaseSUR707.034 · Effective Jan 1, 2026 · Commercial, Medicaid78Original policy ↗
Perinatal Wellness Guidelines57097.0925 · Commercial, Medicaid · TX—Original policy ↗
Perinatal Wellness Guidelines (Spanish)57098.0925 · Commercial, Medicaid · TX—Original policy ↗
Peripheral Subcutaneous Field StimulationMED205.036 · Commercial, Medicaid1Original policy ↗
Periureteral Bulking Agents as a Treatment of Vesicoureteral Reflux (VUR)SUR710.022 · Commercial, Medicaid4Original policy ↗
Photodynamic Therapy for Choroidal NeovascularizationOTH903.015 · Effective Dec 15, 2025 · Commercial, Medicaid9Original policy ↗
Phototherapeutic KeratectomySUR713.023 · Commercial, Medicaid5Original policy ↗
Phrenic Nerve Stimulation for Central Sleep ApneaSUR701.042 · Commercial, Medicaid13Original policy ↗
Physical Medicine and Rehabilitation ServicesCPCP040 · Effective Nov 7, 2025 · Commercial, Medicaid · TX22Original policy ↗
Physical Therapy (PT) and Occupational Therapy (OT) ServicesTHE803.010 · Commercial, Medicaid69Original policy ↗
Plugs for Anal Fistula RepairSUR709.032 · Commercial, Medicaid1Original policy ↗
Pneumatic Compression DevicesRP022 · Effective Jul 17, 2026 · Commercial, Medicaid · TX18Original policy ↗
Point-of-Care Ultrasound Examination PolicyCPCP030 · Effective Dec 19, 2025 · Commercial, Medicaid · TX59Original policy ↗
Polysomnography for Non-Respiratory Sleep DisordersMED201.049 · Commercial, Medicaid6Original policy ↗
Postsurgical Home Use of Limb Compression Devices for Venous Thromboembolism ProphylaxisMED202.073 · Commercial, Medicaid16Original policy ↗
Powered Exoskeleton for Ambulation in Patients With Lower-Limb DisabilitiesDME103.008 · Effective Sep 1, 2026 · Commercial, Medicaid4Original policy ↗
Pozelimab-bbfgRX501.182 · Commercial, Medicaid1Original policy ↗
Prenatal Screening (Nongenetic)CPCPLAB014 · Effective Apr 24, 2026 · Commercial, Medicaid · TX86Original policy ↗
Prenatal Screening (Nongenetic)RPLAB014 · Effective Dec 4, 2026 · Commercial, Medicaid · TX85Original policy ↗
Prescription Medication and Illicit Drug Testing in the Outpatient SettingRPLAB070 · Effective Sep 4, 2026 · Commercial, Medicaid · TX25Original policy ↗
Preventive Care Guidelines763303.0126 · Commercial, Medicaid · TX—Original policy ↗
Preventive Services PolicyRP006 · Effective Jul 1, 2026 · Commercial, Medicaid · TX599Original policy ↗

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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.

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