Infusion Therapy Prior Authorization Requirements for ERS HealthSelect^SM of Texas and Consumer Directed HealthSelect^SM Participants

Below is a clarification regarding the prior authorization requirements through Blue Cross and Blue Shield of Texas (BCBSTX) for Infusion Therapy for HealthSelect of Texas and Consumer Directed HealthSelect participants:

• Home Infusion Therapy (HIT) requires an authorization through BCBSTX, regardless of the drug being administered.
• Infusion Therapy performed in an office setting only requires prior authorization if the drug being administered is listed on the ERS Specialty Drug Prior Authorization List as a specialty drug requiring prior authorization for HealthSelect of Texas and Consumer Directed HealthSelect.

For services that require a referral and/or preauthorization, as noted on the Prior Authorization and Referral Requirements Lists, you can use iExchange^® or call the prior authorization number on the back of the participant’s ID card. iExchange is accessible to physicians, professional providers and facilities contracted with BCBSTX. You can learn more information about iExchange or set up a new account under Clinical Resources on the provider website.

If you have any questions, please contact your Network Management Representative.