Provider Policies

Below are links to our compensation, administrative, and medical policies. You may also access policies and request assistance using Availity® Essentials. Policies are located in the Plan Documents Viewer and can be searched by keywords. Learn more in the Plan Documents Viewer User Guide.

Operational information is in the Provider Manuals' section.

Medical Policy

The purpose of the BCBSMT Medical Policy is to guide coverage decisions and is not intended to influence treatment decisions.

BCBSMT recognizes the rapid changes of technological development and welcomes comments on all medical policies. Email us at

Medical Policy for Out-of-Area Members

Use our Provider Router to access Medical Policy information for out-of-area members. This tool will route you directly to the other Plan's website to view Medical Policy guidelines for an out-of-area member. Click the link below to open the tool and simply enter the member's Alpha Prefix (first three letters of the identification number) located on their ID Card to be routed to the appropriate Plan.

Access the Provider Router

MCG Care Guidelines

Providers can access the MCG Care Guidelines in the BCBSMT-branded Payer Spaces section in  Availity® Essentials under the Resources tab. To locate specific criteria within the MCG Care Guidelines, use CTRL+F.

Compensation Policies

Provider compensation policies are available online using the Plan Documents Viewer application in our BCBSMT-branded Payer Spaces section in the Availity® Essentials portal.

Administrative Policies

Administrative policies are BCBSMT regulations that are not included in provider contracts or medical policy.