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Professional Fee Schedule Request

Please click in the appropriate county section below to access correct Professional Fee Schedule form. If unsure of a county location, rest the cursor on a county for a pop-up box to verify its name.

***Applicable to BCBSTX Contracted Physicians and Providers Only***

Important Note: Physicians/professional providers contracted/affiliated with a capitated IPA/Medical Group must contact IPA/Medical Group for instructions regarding reimbursement related questions. Additionally, physicians/professional providers not part of a capitated IPA/Medical Group but who provide services to a member whose PCP is a member of a capitated IPA/Medical Group must also contact the applicable IPA/Medical Group for instructions.

 El Paso CountyDallam CountySherman CountyHansford CountyOchiltree CountyLipscomb CountyHartley CountyMoore CountyHutchinson CountyRoberts CountyHemphill CountyOldham CountyPotter CountyCarson CountyGray CountyWheeler CountyDeaf SmithRandall CountyArmstrong CountyDonley CountyCollingsworth CountyParmer CountyCastro CountySwisher CountyBriscoe CountyHall CountyChildress CountyBailey CountyLamb CountyHale CountyFloyd CountyMotley CountyCottle CountyFoard CountyCochran CountyHockley CountyLubbock CountyCrosby CountyDickens CountyKing CountyKnox CountyYoakum CountyTerry CountyLynn CountyGarza CountyKent CountyStonewall CountyGaines CountyDawson CountyBorden CountyScurry CountyAndrews CountyMartin CountyHoward CountyMitchell CountyHaskell CountyThrockmorton CountyYoung CountyFisher CountyJones CountyShackelford CountyStephens CountyPalo Pinto CountyNolan CountyTaylor CountyCallahan CountyEctor CountyMidland CountyGlasscock CountySterling CountyCoke CountyRunnels CountyColeman CountyUpton CountyRegan CountyIrion CountyTom Green CountyMcCulloch CountyHudspeth CountyConcho CountyEastland CountyComanche CountyBrown CountyMills CountyWinkler CountySan Saba CountyLoving CountyWard CountyCrane CountyCulberson CountyReeves CountyPecos CountyCrockett CountySchleicher CountyMenard CountyMason CountyBurnet CountySutton CountyKimble CountyJeff Davis CountyPresidio CountyBrewster CountyTerrell CountyVal Verde CountyEdwards CountyBaylor CountyWilbarger CountyHardeman CountyWichita CountyClay CountyArcher CountyJack CountyMontague CountyCooke CountyGrayson CountyWise CountyDenton CountyCollin CountyParker CountyTarrant CountyDallas CountyHunt Rockwall CountyKaufman CountyHood CountyErath Somervell CountyJohnson CountyEllis CountyNavarro CountyHill CountyBosque CountyFannin CountyLamar Delta CountyBowie CountyHopkins CountyRed  River Franklin CountyTitus CountyCamp CountyMorris Cass CountyWood Rains CountyUpshur CountyMarion CountyVan Zandt CountyGregg Smith CountyHarrison CountyHenderson CountyFreestone CountyAnderson CountyCherokee CountyRusk CountyPanola CountyHamilton CountyMcLennan CountyCoryell CountyFalls CountyLampasas CountyBell CountyLlano CountyWilliamson CountyMilam CountyBurleson CountyGillespie CountyKerr CountyKendall CountyBlanco CountyTravis CountyHays CountyLee CountyBastrop CountyComal CountyCaldwell CountyGuadalupe CountyGonzales CountyFayette CountyLimestone CountyRobertson CountyLeon Madison CountyHouston CountyTrinity CountyAngelina CountyNacogdoches CountyShelby CountySan Augustine CountySabine CountyBrazos CountyGrimes CountyWalker CountyPolk CountySan Jacinto Liberty CountyTyler CountyJasper CountyNewton CountyOrange CountyHardin CountyJefferson CountyMontgomery CountyWashington CountyAustin CountyWaller CountyHarris CountyChambers CountyColorado CountyFort Bend CountyLavaca CountyWharton CountyGalveston CountyDewitt CountyGoliad CountyVictoria CountyCalhoun CountyJackson CountyMatagorda CountyBrazoria CountyKinney CountyReal CountyBandera CountyUvalde CountyMedina CountyBexar CountyWilson CountyKarnes CountyBee CountyRefugio CountyAransas CountyAransas CountySan Patricio CountyNueces CountyMaverick CountyZavala CountyFrio CountyAtascosa CountyDimmit CountyLa Salle CountyMcMullen CountyLive Oak CountyWebb CountyDuval CountyJim Wells CountyKleberg CountyZapata CountyJim Hogg CountyBrooks CountyKenedy CountyStarr CountyHidalgo CountyWillacy CountyCameron County


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