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For Providers
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December 2025 |
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BEHAVIORAL HEALTH |
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See Updates to Behavioral Health Clinical Practice Guidelines
The guidelines are based on established evidence‑based standards and support decision‑making processes in member care.
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CLAIMS AND ELIGIBILITY |
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Use the Correct Place of Service Code When Filing Claims
If the wrong POS code is used, your claim could be denied or payment could be delayed. See POS code examples for various service locations.
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Review Prior Authorization Changes for Commercial Plans
Effective Jan. 1, 2026, prior authorization requirements for certain commercial plans are changing to reflect new, replaced or removed codes.
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EDUCATION |
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Explore Learning Opportunities
We offer free training for providers who participate in our networks. Review and sign up for sessions.
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NETWORK PARTICIPATION |
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Keep Your Record ID Active To Prevent Network Termination
If you haven’t filed a claim with your billing or rendering National Provider Identifier and Tax Identification Number with a date of service within 24 months, we may cancel your corresponding record ID, and you may be terminated from our networks. Learn how to keep your record ID active with us.
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PHARMACY |
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Review Pharmacy Program Quarterly Update – Part 1
Changes were made to our drug lists and utilization management program. Learn about these and other pharmacy program updates.
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STANDARDS AND REQUIREMENTS |
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Watch for Expanded Laboratory Benefit Management Program
Effective Jan. 1, 2026, we’ll offer our laboratory claims review program for routine outpatient laboratory services provided to more of our commercial members.
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We’re Renaming Coding and Compensation Policies to Reimbursement Policies
Starting Jan. 1, 2026, the policies will have a new name. They’ll continue to be a resource for general information on billing and coding.
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Learn About Updates to Coding and Compensation Policies
We regularly add and modify coding and compensation policies as part of our ongoing policy review. See which policies were updated and when.
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Review Active and Pending Medical Policies
Approved new or revised medical policies and their effective dates are usually posted on our website the first and 15th of each month. You can view all active and pending policies, as well as draft medical policies, and provide comments on draft policies. These policies may impact your reimbursement and your patients’ benefits.
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Contact Us
Contact information for Network Representatives and other resources is on our website.
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Blue Cross and Blue Shield of Montana, a Division of Health Care Service Corporation,
a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association
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3645 Alice St., Helena, MT 59601
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