Reimbursement Policy Updates

Sept. 22, 2026 

Reimbursement policies, formerly known as clinical payment and coding policies, describe payment rules and methodologies for Current Procedural Terminology (CPT®) codes, Healthcare Common Procedure Coding System and ICD-10 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 reimbursement policy positions as part of our ongoing policy review process.   

The following policies were updated:

Reimbursement Policies 

  • Advanced Member Notification Policy, effective Sept. 1, 2026
  • Advanced Member Notification Policy Form, effective Sept. 1, 2026
  • Assistant at Surgery Reimbursement Policy, effective Oct. 1, 2026
  • Assistant Surgery Codes, effective Oct. 1, 2026
  • CDT, CPT, HCPCS, ICD-10-PCS Code and ICD-10-CM Update Policy, effective Sept. 15, 2026
  • Fee Schedule Clerical Error Policy, effective Sept. 16, 2026
  • HMK Therapeutic Group Home Policy, effective July 1, 2026
  • Hospital Reimbursement Policy, effective Sept. 9, 2026
  • Infusion Therapy Code List, archived as of Dec. 10, 2026
  • Infusion Therapy Reimbursement Policy, effective Dec. 11, 2026
  • Non-Reimbursable Experimental, Investigational and/or Unproven Services Reimbursement Policy - Non-Reimbursable EIU Services, effective Sept. 11, 2026
  • Place of Service Reimbursement Policy, effective Sept. 16, 2026
  • RBRVS Reimbursement Policy, effective Sept. 16, 2026
  • Sports Physical Reimbursement Policy, effective Sept. 21,2026
  • Telehealth Reimbursement Policy, effective Sept. 1, 2026
  • Telehealth Service Codes, effective Sept. 1, 2026
  • Website Publication Policy, effective Sept. 21, 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. 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.