BCBSTX Medical Policies and BCBSTX Clinical Payment and Coding Policies
Blue Cross and Blue Shield of Texas (BCBSTX) Medical Policies are based on scientific and medical research. They are often used as guidelines for coverage determinations in health care benefit programs. View Medical Policies.
BCBSTX Clinical Payment and Coding Policies are based on criteria developed by specialized professional societies, national guidelines (e.g., Milliman Care Guidelines) and the CMS Provider Reimbursement Manual. Additional sources are used and can be provided upon request. The Clinical Payment and Coding Guidelines are not intended to provide billing or coding advice, but to serve as a reference. View Clinical Payment and Coding Policies.