08/15/2024
What’s changing?
Effective Nov. 18, 2024, Blue Cross and Blue Shield of Texas is updating its Clinical Payment and Coding Policy, CPCP024 Evaluation and Management Coding – Professional Provider Services.
The Details
Under this revised policy BCBSTX will no longer reimburse for outpatient or inpatient consultations using Current Procedural Terminology (CPT®) codes 99242 - 99245 and 99252 - 99255. Consultation services should be reported with an appropriate office outpatient or inpatient evaluation and management code representing the location where the visit occurred and the level of complexity of the visit performed.
What do I need to do?
Refer to the Clinical Payment and Coding Policy page and review the revised policy CPCP024 Evaluation and Management Coding in detail and code claims consistent with the policy.
If you have any questions or if you need additional information, please contact your BCBSTX Network Management Representative.
Clinical payment and coding policies are based on using healthcare professionals and industry standard guidelines. The clinical payment and coding guidelines are not intended to provide billing or coding advice but to serve as a reference for facilities and providers.
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