Upcoming Modifications to UM Guidelines BlueCross BlueShield of Tennessee

Guidelines to be effective December 2, 2025:

Ambulatory Care (AC):

• Medical Nutrition Therapy for Dietary Counseling - this Supplemental Utilization Management Guideline will be archived in favor of CMS, NCD - Medical Nutrition Therapy (180.1)

• Smoking Cessation - this Supplemental Utilization Management Guideline will be archived in favor of CMS, NCD - Counseling to Prevent Tobacco Use (210.4.1)

Home Care (HC):

• Hyperemesis Gravidarum

To view all Guidelines modified by BlueCross BlueShield of Tennessee - http://www.bcbst.com/providers/UM_Guidelines/.