Choose the payer and product, then open the payer’s own list or lookup. Check its current dates and plan scope.
Substrate is used by billers at:
State filters show explicitly state-tagged sources. Other sources may apply to your plan. Search procedure codes in the payer’s official source.
3 official sources
Blue Cross and Blue Shield of Texas
Fully insured commercial members and certain ASO groups. Check the source for group and setting exceptions.
Scope reviewed · PDF
Open official listBlue Cross and Blue Shield of Texas
Medicare Advantage PPO and HMO products. Check the document’s effective dates and benefit scope.
Scope reviewed · PDF
Open official listBlue Cross and Blue Shield of Texas
Texas Medicaid products. Check the source for service qualifications and effective dates.
Scope reviewed · PDF
Open official listA list can vary by product, service setting, date or delegated reviewer. The original payer source governs; these links do not provide a member-specific authorization answer.
Find another payer’s official lists · View Blue Cross and Blue Shield of Texas payer profile
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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.
