For details on behavioral health components for our government programs members, refer to the appropriate Blue Cross and Blue Shield of Illinois (BCBSIL) Provider Manual.
Also refer to the Support Materials (Government Programs) page in the general Utilization Management section. This page includes prior authorization requirement summaries, procedure code lists and related information that may be applicable to some members with the following benefit plans:
- Illinois Medicaid – Blue Cross Community Health PlansSM (BCCHP)SM and Blue Cross Community MMAI (Medicare-Medicaid Plan)SM
- Blue Cross Medicare Advantage (PPO)SM (MA PPO)
If you need more information on BCBSIL’s government programs products, programs and initiatives, contact your assigned Provider Network Consultant (PNC). Your PNC can also help with questions on contractual compliance and training opportunities for behavioral health providers who serve our government programs members.
All behavioral health benefits are subject to the terms and conditions as listed in the member’s benefit plan.
Checking eligibility and/or benefit information and/or obtaining prior authorization is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member’s certificate of coverage, including, but not limited to, exclusions and limitations applicable on the date services were rendered. If you have any questions, call the number on the member’s ID card.