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.




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

Eastland Jack Throckmorton
Erath Palo Pinto Wilbarger
Haskell Stephens Young

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

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

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

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