Feb. 23, 2026
Reimbursement policies, formerly known as coding and compensation policies, describe payment rules and methodologies for Current Procedural Terminology (CPT®) codes, Healthcare Common Procedure Coding System and ICD-10-CM coding for claims submitted as covered services. This information is a resource for our payment policies. It’s not intended to address all reimbursement-related issues. We regularly add and modify coding and compensation policy positions as part of our ongoing policy review process.
The following policies were updated:
- Autism Compensation Policy - Applied Behavioral Analysis, effective May 20, 2026
- CPCPLAB003 Vitamin D, effective May 1, 2026
- CPCPLAB008 Diagnostic Testing of Iron Homeostasis and Metabolism, effective May 1, 2026
- CPCPLAB009 Testosterone Testing, effective May 1, 2026
- CPCPLAB010 Vitamin B12 and Methylmalonic Acid Testing, effective May 1, 2026<
- CPCPLAB014 Prenatal Screening, effective April 24, 2026
- CPCPLAB023 Diagnosis of Idiopathic Environmental Intolerance, effective May 1, 2026
- CPCPLAB027 Testing for Diagnosis of Active or Latent Tuberculosis, effective April 24, 2026
- CPCPLAB028 Immune Cell Function Assay, effective May 1, 2026
- CPCPLAB038 Urinary Tumor Markers for Bladder Cancer, effective May 1, 2026
- CPCPLAB045 Pathogen Panel Testing, effective April 24, 2026
- CPCPLAB051 Diagnostic Testing of Common Sexually Transmitted Infections, effective April 24, 2026
- CPCPLAB064 Nerve Fiber Density Testing, effective May 1, 2026
- CPCPLAB069 Immunohistochemistry, effective May 1, 2026
- CPCPLAB070 Prescription Medication and Illicit Drug Testing, effective April 24, 2026
- CPCPLAB067 Testing for Homocysteine Metabolism Related Conditions, effective May 1, 2026
- Telehealth Compensation Policy, effective Feb. 1, 2026
- Telehealth Services Codes effective Feb. 1, 2026
- Non-Reimbursable Experimental, Investigational and/or Unproven Services Compensation Policy- Non-Reimbursable EIU Services, effective Jan. 1, 2026
- Non-Reimbursable Experimental, Investigational and/or Unproven Services Compensation Policy Non-Reimbursable EIU Services Denied Codes, effective Jan. 1, 2026
- Assistant at Surgery Compensation Policy effective Feb. 3, 2026
- Assistant Surgery Codes effective Feb. 3, 2026
For more details, refer to the revised policies in Availity® Essentials through the Plan Documents Viewer application. You can access the application in Payer Spaces for Blue Cross and Blue Shield of Montana.
CPT copyright 2025 American Medical Association. All rights reserved. CPT is a registered trademark of the AMA.
Reimbursement Policies (formerly known as Coding and Compensation Policies) are based on health care professionals’ and industry standard guidelines. The reimbursement guidelines are not intended to provide billing or coding advice but to serve as a reference for facilities and providers.
The information provided does not constitute coding or legal advice. Physicians and other health care providers should use their own medical judgment based upon all available information and the condition of the patient in determining the appropriate course of treatment, and to submit claims using the most appropriate code(s) based upon the medical record documentation, coding guidelines and reference materials.
Availity is a trademark of Availity, LLC, a separate company that operates a health information network to provide electronic information exchange services to medical professionals. Availity provides administrative services to BCBSMT. BCBSMT makes no endorsement, representations or warranties regarding third party vendors and the products and services they offer.