Professional Fee Schedule Request

Please Note:

  • This Fee Schedule Request Form is applicable to Blue Cross and Blue Shield of Texas (BCBSTX) Participating Physicians and Professional Providers Only.
  • Dental (DDS) providers, contracted with the Dental Network of America (DNOA, must email DNOA for reimbursement related questions or fee schedule requests.
  • Non-contracting provider reimbursement, contact Provider Customer Service at 1-800-451-0287 for reimbursement information.

How to Request

Access the BCBSTX participating physician and professional provider Fee Schedule Request Form by selecting the county where services are provided from the Area/County List below. Complete the form and select Submit to receive the appropriate professional fee schedule(s).

If your provider services more than one county in the same area list, you will only need to request the fee schedule once.

If the provider services more than one county and they are not in the same area list, you will need to request the fee schedule for each area.

Important Note:

Providers contracted/affiliated with a capitated Independent Practice Association (IPA)/Medical Group or providers who are not part of a capitated IPA/Medical Group but who provide services to a member whose PCP is part of a capitated IPA/Medical Group must contact the IPA/Medical Group for instructions regarding reimbursement related questions.

Dental (DDS) providers, contracted with the Dental Network of America (DNOA, must email DNOA for reimbursement related questions or fee schedule requests.

  • City of Austin and surrounding counties

    Bastrop Fayette McLennan
    Bell Hays Milam
    Bosque Hill Robertson
    Burleson Lee Travis
    Burnet Leon Williamson
    Caldwell Limestone  
    Falls Madison  
  • El Paso County

    El Paso

  • City of Lubbock and surrounding counties

    Eastland Jack Throckmorton
    Erath Palo Pinto Wilbarger
    Haskell Stephens Young
  • Cities of Amarillo, Dallas, Fort Worth, Paris, Texarkana, Longview, Tyler and surrounding counties

    Armstrong Foard Lubbock Van Zandt
    Bailey Franklin Lynn Wheeler
    Baylor Garza Marion Wichita
    Bowie Gray Montague Wise
    Briscoe Grayson Moore Wood
    Camp Gregg Morris Yoakum
    Carson Hale Motley  
    Cass Hall Navarro  
    Castro Hansford Ochiltree  
    Childress Hardeman Oldham  
    Clay Harrison Parker  
    Cochran Hartley Parmer  
    Collin Hemphill Potter  
    Collingsworth Henderson Rains  
    Cooke Hockley Randall  
    Cottle Hood Red River  
    Crosby Hopkins Roberts  
    Dallam Hunt Sherman  
    Dallas Hutchinson Smith  
    Deaf Smith Kaufman Somervell  
    Delta Kent Stonewall  
    Denton King Swisher  
    Donley Knox Tarrant  
    Ellis Lamar Terry  
    Fannin Lamb Titus
    Floyd Lipscomb Upshur
  • Cities of Midland and Odessa (and surrounding counties)

    Andrews Glasscock Mitchell
    Blanco Hamilton Nolan
    Borden Howard Pecos
    Brewster Hudspeth Presidio
    Brown Irion Reagan
    Callahan Jeff Davis Reeves
    Coke Jones Runnels
    Coleman Kerr San Saba
    Comanche Kimble Scurry
    Concho Kinney Shackelford
    Coryell Lampasas Schleicher
    Crane Llano Sterling
    Crockett Loving Sutton
    Culberson Martin Taylor
    Dawson Mason Terrell
    Ector Maverick Tom Green
    Edwards McCulloch Upton
    Fisher Menard Val Verde
    Gaines Midland Ward
    Gillespie Mills Winkler
  • Cities of Brownsville, Corpus Christi and San Antonio (and surrounding counties)

    Aransas Gonzales Nueces
    Atascosa Guadalupe Real
    Bandera Hidalgo Refugio
    Bee Jim Hogg San Patricio
    Bexar Jim Wells Starr
    Brooks Karnes Uvalde
    Cameron Kendall Webb
    Comal Kenedy Willacy
    DeWitt Kleberg Wilson
    Dimmit La Salle Zapata
    Duval Live Oak Zavala
    Frio McMullen
    Goliad Medina
  • Cities of Beaumont, Houston, Nacogdoches and surrounding counties

    Anderson Harris Polk
    Angelina Houston Rusk
    Austin Jackson Sabine
    Brazoria Jasper San Augustine
    Brazos Jefferson San Jacinto
    Calhoun Lavaca Shelby
    Chambers Liberty Trinity
    Cherokee Matagorda Tyler
    Colorado Montgomery Victoria
    Freestone Nacogdoches Walker
    Fort Bend Newton Waller
    Galveston Orange Washington
    Hardin Panola Wharton