Blue Shield of California (BSC)
Effective Jan. 1, 2026, Magellan* will no longer manage the behavioral health services for Blue Shield of California members.
To continue as an in-network provider serving these members on and after Jan. 1, 2026, you’ll need to follow BSC's processes to become a contracted provider. Email BSC at [email protected] or visit BSC's website for more information on joining their network.
For dates of service through Dec. 31, 2025, continue with current processes via Magellan. For dates of service on and after Jan. 1, 2026, verify eligibility and benefits, obtain prior authorization, and submit claims following BSC's processes.
We’ll publish further details and resources as they become available.
California Quick Reference Guide (PDF)
Medical Necessity Criteria
- Medical Necessity Criteria for BSC - see State/Client-Specific Criteria for California
- For key points relating to SB 855, see Handbook Supplement for California (PDF), section 3.
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).
Maternal Mental Health
BSC offers support to moms-to-be and their partners during and after pregnancy through the Maven Maternity Program.*
Services include:
- On-demand virtual appointments with Maven OB-GYNs, lactation consultants, doulas, mental health specialists, nutritionists, career coaches, and more
- Assigned care advocate to help navigate health plan benefits and providers, and find in-person care
- Educational resources
*In accordance with State Bill 1207 (Health care coverage: maternal and pandemic-related mental health conditions)
Applied Behavior Analysis
- For ABA Initial Authorization and Treatment Request / Concurrent Review forms and contact information, sign in to this website. From the Resources section, select State & Plan Information, then choose Autism.
- 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.
Post-Stabilization Care
Magellan Healthcare, Inc.* manages the behavioral health benefits for full-service health plan members.
In the event a member whose behavioral health benefit is managed by Magellan receives emergency services at your facility and requires post-stabilization care for a behavioral health diagnosis, and you are not a participating provider with Magellan, contact us at 1-877-263-9952 (Blue Shield of California MHSA) to review the member’s ongoing care needs.
*In California, Magellan does business as Human Affairs International of California and/or Magellan Health Services of California, Inc. – Employer Services.