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.

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.

Explore Learning Opportunities

We offer free training for providers who participate in our networks. Review and sign up for sessions.

See Program Results for Blue Cross Medicare Advantage Dual Care^SM

Every year, we measure how we’re meeting the goals for our Dual Care programs, which serve older adults and people with disabilities. See the 2024 results for Blue Cross Medicare Advantage Dual Care Plus (HMO SNP)^SM and Blue Cross Medicare Advantage Dual Care Plus Preferred (PPO SNP)^SM.

Support Quality Care by Keeping Your Data Updated in the NPI Registry

If you have a National Provider Identifier, update the NPI Registry promptly when your practice or other information changes, in addition to updating us. Learn why accurate data matters for quality reporting.

Keep Your Record ID Active To Prevent Network Termination

If you haven’t filed a claim with your billing or rendering NPI 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.

See 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.

See Updates to Provider Reference Manuals

Our 2026 provider reference manuals are updated, effective Jan. 1, 2026. The manuals are available online. Please review them for all changes.

• Provider Reference Manual 

• Medicaid Provider Reference Manual 

• Medicare Advantage Provider Reference Manual 

We’re Renaming Clinical Payment and Coding 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.

Learn About Updates to Clinical Payment and Coding Policies

We regularly add and modify CPCPs as part of our ongoing policy review. See which policies were updated and when.

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.

Talk with Members About Access to Contraceptive Care

For members with Turquoise Care, we track U.S. Department of Health and Human Services’ quality measures on contraceptive care to help close potential care gaps. Learn what data is measured.