Blue Shield of California (BSC)
Interested in joining Magellan’s network for BSC Medi-Cal and Medicare plans?
Learn more by emailing [email protected]. To participate, you must also enroll with Medi-Cal through the California DHCS.
California Quick Reference Guide (PDF)
Medical Necessity Criteria
- Medical Necessity Criteria for BSC
- For key points relating to SB 855, see Handbook Supplement for California (PDF), section 3.
- 2021-2022 California Review Criteria / Guidelines Grid (PDF)
Access Standards
We expect you to return member's call in accordance with good professional practice guidelines. For more information, refer to the California provider handbook supplement, section 3 (PDF).
Applied Behavior Analysis
Visit our California ABA COVID-19 webpage for information on using telehealth for ABA during the crisis.
For BSC-specific ABA resources, sign in to this website. From the Resources section, select State & Plan Information, then choose Blue Shield of California.
In-Office Injectable Medications
Obtaining In-Office Injectable Medications (PDF)
How to Access In-Office Injectable Policies on BSC Provider Portal (PDF)
Prescription Drug Prior Authorization or Step Therapy Exception Request Form (PDF)
California Provider Information
Visit the California webpage for the California handbook supplement and other important resources, such as a California provider orientation and quick reference guide.
Out-of-Network Providers
Out-of-Network Authorization Request Form -- for out-of-network providers requesting a single case agreement. Contact the phone number on the member ID card for more information.