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Health care benefit programs issued or administered by Capital BlueCross and/or its subsidiaries, Capital Advantage Insurance Company^®, Capital Advantage Assurance Company^® and Keystone Health Plan^® Central. Independent licensees of the BlueCross BlueShield Association serving 21 counties in Central Pennsylvania and the Lehigh Valley. Communications issued by Capital BlueCross in its capacity as administrator of programs and provider relations for all companies.

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Administrative bulletins

Topic index: February 2026

Topic	Location
Appeals
Appeals and medical records submissions through Capital's Provider portal	AB2026-02-001
Coming soon – Appeals and medical records submissions through Capital’s Provider Portal	AB2026-01-001
Postponed: Appeals and Medical Records Submissions Through Capital’s Provider Portal	AB2026-03-001
Prime Therapeutics (Prime) medical drug management – Specialty injectable medications	AB2026-01-002
Availity
Appeals and medical records submissions through Capital's Provider portal	AB2026-02-001
Coming soon – Appeals and medical records submissions through Capital’s Provider Portal	AB2026-01-001
Fee schedule on Provider Portal – Now accessible to chiropractors	AB2026-01-001
Postponed: Appeals and Medical Records Submissions Through Capital’s Provider Portal	AB2026-03-001
BlueCard
Capital Blue Cross BlueCard Executive Contact – MDL settlement	AB2026-02-001
CapBlueCross.com
CapBlueCross.com launches new, improved Provider website	AB2026-01-001
Cardiac Services
TurningPoint – Expansion of Cardiology Program – Delegated Services and Medical Policies	AB2026-03-001
Chiropractic services
Chiropractic coding – Reimbursement policy and claims editing system updates	AB2026-01-001
Fee schedule on Provider Portal – Now accessible to chiropractors	AB2026-01-001
Claims
Capital Blue Cross BlueCard Executive Contact – MDL settlement	AB2026-02-001
Chiropractic coding – Reimbursement policy and claims editing system updates	AB2026-01-001
Claims editing system - Inappropriate use of modifiers 59, XE, XP, XS, and XU	AB2026-01-001
Claims editing system – Recovery room without anesthesia	AB2026-02-001
Services not provided directly to members are not covered – H0032	AB2026-01-001
Coding
Claims editing system - Inappropriate use of modifiers 59, XE, XP, XS, and XU	AB2026-01-001
Claims editing system – Recovery room without anesthesia	AB2026-02-001
Chiropractic coding – Reimbursement policy and claims editing system updates	AB2026-01-001
Radiology procedure coding update – Anatomical modifiers	AB2026-02-001
Services not provided directly to members are not covered – H0032	AB2026-01-001
TurningPoint (TP) – Musculoskeletal (MSK) procedure code substitutions for orthopedic surgeries	AB2026-01-001
Credentialing
New graduates requesting to join the network	AB2026-02-002
Customer support
Provider change notifications	AB2026-02-002
Fee schedule
Fee schedule on Provider Portal – Now accessible to chiropractors	AB2026-01-001
Genetic Counseling
Reimbursement Policy Updates	AB2026-03-001
Healthcare Effectiveness Data and Information Set (HEDIS®)
Colorectal Cancer Screening (COL)	AB2026-03-003
Medical Record Collection for Quality Reporting of HEDIS®	AB2026-03-003
Plan All-Cause Readmeddeeission (PCR)	AB2026-03-003
Medicare Advantage
Annual Review and Updates to Prime Therapeutics™ Guidelines	AB2026-03-002
Single source preauthorization list updates	AB2026-01-001
Claims editing system – Inappropriate use of modifiers 59, XE, XP, XS, and XU	AB2026-01-001
Payment integrity audit concepts – Medicare inpatient-only procedures	AB2026-02-002
Prime Therapeutics (Prime) – Continuity of Care	AAB2026-03-002
Medical injectables
Prime Therapeutics (Prime) medical drug management – Specialty injectable medications	AB2026-01-002
Medical policy
Evolent – CG-2068 for Brain and Neck Computed Tomography Angiography (CTA) – New Medical Policy	AB2026-03-001
Evolent – High-tech radiology, cardiac imaging, and radiation oncology – Annual review of delegated services and medical policy criteria	AB2026-01-001
Evolent – High-tech radiology, cardiac imaging, and radiation oncology - Medical policy updates	AB2026-02-001
Notification of new and revised medical policies and preauthorization requirements	AB2026-01-003
Notification of new and revised medical policies and preauthorization requirements	AB2026-02-003
TurningPoint – Expansion of Cardiology Program – Delegated Services and Medical Policies	AB2026-03-001
TurningPoint- Expansion of Musculoskeletal (MSK) Program – Delegated Services and Medical Policies	AB2026-03-001
TurningPoint – OR-1039 for Thermal Intradiscal Procedures – New Medical Policy	AB2026-03-001
Notification of New and Revised Medical Policies and Preauthorization Requirements	AB2026-03-005
Member ID cards
Shared administrative services expansion – I.B. Abel, Inc	AB2026-01-001
Musculoskeletal (MSK)
TurningPoint- Expansion of Musculoskeletal (MSK) Program – Delegated Services and Medical Policies	AB2026-03-001
TurningPoint (TP) – Musculoskeletal (MSK) procedure code substitutions for orthopedic surgeries	AB2026-01-001
TurningPoint – OR-1039 for Thermal Intradiscal Procedures – New Medical Polices	AB2026-03-001
National Committee for Quality Assurance (NCQA)
Provider appointment availability standards.	AB2026-02-002
Provider Appointment Availability Survey Coming in May	AB2026-03-001
Oncology
Evolent – High-tech radiology, cardiac imaging, and radiation oncology – Annual review of delegated services and medical policy criteria	AB2026-01-001
Evolent – High-tech radiology, cardiac imaging, and radiation oncology - Medical policy updates	AB2026-02-001
Preauthorization
Ensuring Continuity of Care when patients change health plans	AB2026-01-001
Prime Therapeutics (Prime) – Continuity of Care	AB2026-03-002
Prime Therapeutics (Prime) medical drug management – Specialty injectable medications	AB2026-01-002
Single source preauthorization list updates	AB2026-01-001
Single source preauthorization list updates	AB2026-02-001
Single source preauthorization list updates	AB2026-03-001
TurningPoint – Expansion of Cardiology Program – Delegated Services and Medical Policies	AB2026-03-001
TurningPoint- Expansion of Musculoskeletal (MSK) Program – Delegated Services and Medical Policies	AB2026-03-001
TurningPoint (TP) – Musculoskeletal (MSK) procedure code substitutions for orthopedic surgeries	AB2026-01-001
Preventive services
Preventive services health coverage guidelines — 2026 Updates	AB2026-01-001
Colorectal Cancer Screening (COL)	AB2026-03-003
Prime
Prime Therapeutics (Prime) medical drug management – Specialty injectable medications	AB2026-01-002
Provider attestation
CAQH attestation – Reminder	AB2026-02-002
Provider data attestation and demographic updates.	AB2026-02-002
Provider demographics
Provider data attestation and demographic updates.	AB2026-02-002
Provider manual
Provider appointment availability standards	AB2026-02-002
Provider Appointment Availability Survey Coming in May	AB2026-03-001
Quality
Colorectal Cancer Screening (COL)	AB2026-03-003
Medical Record Collection for Quality Reporting of HEDIS®	AB2026-03-003
Plan All-Cause Readmission (PCR)	AB2026-03-003
Radiology
Evolent – CG-2068 for Brain and Neck Computed Tomography Angiography (CTA) – New Medical Policy	AB2026-03-001
Evolent – High-tech radiology, cardiac imaging, and radiation oncology – Annual review of delegated services and medical policy criteria	AB2026-01-001
Evolent – High-tech radiology, cardiac imaging, and radiation oncology - Medical policy updates	AB2026-02-001
Radiology procedure coding update – Anatomical modifiers	AB2026-02-001
Reimbursement
Chiropractic coding – Reimbursement policy and claims editing system updates	AB2026-01-001
Claims editing system – Inappropriate use of modifiers 59, XE, XP, XS, and XU	AB2026-01-001
Claims editing system – Recovery room without anesthesia	AB2026-02-001
New reimbursement policy - FR-02.004, Critical care when patient is discharged to home	AB2026-02-001
Payment integrity audit concepts – Medicare inpatient-only procedures	AB2026-02-002
Radiology procedure coding update – Anatomical modifiers	AB2026-02-001
Reimbursement policy updates	AB2026-02-001
Reimbursement Policy Updates	AB2026-03-001
Services not provided directly to members are not covered – H0032	AB2026-01-001
Shared Administrative Services (SAS)
Shared Administrative Services expansion – I.B. Abel, Inc	AB2026-01-001
TurningPoint
TurningPoint (TP) – Musculoskeletal (MSK) procedure code substitutions for orthopedic surgeries	AB2026-01-001
TurningPoint’s Provider web portal enhancement integrates SmartScan AI	AB2026-02-001
Utilization Management
Concurrent Review – Continued Stay Timeframes	AB2026-03-004
Plan All-Cause Readmission (PCR)	AB2026-03-003
Value-based programs
2026 Commercial and Medicare gaps in care measures	AB2026-01-001
Women’s health
Preventive services health coverage guidelines — 2026 Updates	AB2026-01-001

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Administrative bulletins

Topic index: February 2026

Topic

Location

Appeals

Availity

BlueCard

CapBlueCross.com

Cardiac Services

Chiropractic services

Claims

Coding

Credentialing

Customer support

Fee schedule

Genetic Counseling

Healthcare Effectiveness Data and Information Set (HEDIS®)

Medicare Advantage

Medical injectables

Medical policy

Member ID cards

Musculoskeletal (MSK)

National Committee for Quality Assurance (NCQA)

Oncology

Preauthorization

Preventive services

Prime

Provider attestation

Provider demographics

Provider manual

Quality

Radiology

Reimbursement

Shared Administrative Services (SAS)

TurningPoint

Utilization Management

Value-based programs

Women’s health