Blue Cross Blue Shield

Regence BlueCross BlueShield

(Regence)

Regence BlueCross BlueShield serves over 2.4 million members across four western states. Part of Cambia Health Solutions, Regence focuses on transforming health care with innovative solutions and comprehensive coverage.

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States Served

Nationwide presence

2.4+

Members

Covered lives

N/A

Market Share

National presence

Over

Network Size

Healthcare providers

Behavioral Health Coverage

Regence provides comprehensive behavioral health benefits with emphasis on access, integration, and evidence-based treatment across their four-state service area. They contract with facilities to form networks essential for delivering behavioral health services.

Managed by: Direct management with partnerships including Boulder Care for MAT, AbleTo, Talkspace, Doctor On Demand, and MDLIVE

Covered Levels of Care

Inpatient psychiatric

Residential treatment

Partial hospitalization (PHP)

Intensive outpatient (IOP)

Virtual PHP (G0017)

Virtual IOP (G0018)

Outpatient therapy

Medication-assisted treatment (MAT)

Program Strengths

Extensive regional network

Strong telehealth coverage including virtual PHP/IOP

Integrated care programs with collaborative care codes

Comprehensive autism coverage

Substance use disorder benefits with MAT through Boulder Care

Preventive mental health focus

7-day follow-up requirement after facility discharge

Facility Certification Requirements

State license in Regence service area
NPI number required
Professional liability insurance
CAQH registration - must be complete for credentialing
DEA registration (for facilities with prescribers)
Facility accreditation (JCAHO, CARF, or state certification)
Compliance with state facility licensing requirements

Medical Necessity Criteria: InterQual Behavioral Health Criteria and MCG guidelines for medical necessity determinations

Geographic Coverage

Regence BlueCross BlueShield provides coverage in 4 states across the United States

Idaho

Oregon

Utah

Washington

Headquarters:Portland, Oregon

Ready to Contract with Regence BlueCross BlueShield?

Our team specializes in helping behavioral health facilities navigate the Regence BlueCross BlueShield contracting process. We'll help you secure competitive rates and streamline your credentialing.

Credentialing Support

Complete CAQH and enrollment assistance

Rate Negotiation

Strategic approach to maximize reimbursement

Application Management

End-to-end application preparation

Follow-up Tracking

Persistent follow-up until contracted

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