Highlights

Key Updates

Education & Training WebinarsAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageAugust 1, 2025

You are invited: immunization measures webinar

Products & Programs PharmacyAnthem Blue Cross and Blue Shield | CommercialJuly 24, 2025

Specialty pharmacy updates — August 2025

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageJuly 23, 2025

Enhance care provider data accuracy with updated roster tools

Policy Updates Prior AuthorizationAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageJuly 1, 2025

Benefits of utilization management attestations: a guide for care providers


What's New

Recent Updates

Products & Programs PharmacyAnthem Blue Cross and Blue Shield | Medicare AdvantageAugust 1, 2025

Expanded specialty pharmacy precertification list

Products & Programs Federal Employee Program (FEP)Anthem Blue Cross and Blue Shield | CommercialAugust 1, 2025

Changes to Federal Employees Health Benefits program and Postal Service Health Benefits program telemedicine services

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2025

SUD confidentiality protections for members

Education & TrainingAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2025

Support your patients with the CarelonRx, Inc. and Lark Weight Management Program

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2025

Notice of material change/amendment to contract

Notices of material changes/amendments to contract — August 2025

Education & Training WebinarsAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageAugust 1, 2025

You are invited: immunization measures webinar

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2025

Notice of material change/amendment to contract

Facility diagnostic radiopharmaceuticals and contrast media

Quality ManagementAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageAugust 1, 2025

Compatibility in care: sharing REL data to improve member health

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2025

Upcoming updates: medical claims edit system for self‑administered drugs

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2025

New EMR messaging alerts aim to close gaps in care for ACA patients

Policy Updates Medical Policy & Clinical GuidelinesAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2025

Notice of material change/amendment to contract

Medical Policy and Clinical Guideline updates

Effective November 1, 2025

Behavioral HealthAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2025

Introducing a new Applied Behavior Analysis Provider Resource Guide

Products & Programs PharmacyAnthem Blue Cross and Blue Shield | CommercialAugust 1, 2025

Notice of material change/amendment to contract

Clinical Criteria updates for specialty pharmacy

Effective November 1, 2025

Policy UpdatesAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageJuly 28, 2025

Clinical Criteria updates

Effective September 4, 2025

Policy Updates Medical Policy & Clinical GuidelinesAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageJuly 25, 2025

Medical Policies and Clinical Utilization Management Guidelines update

Effective August 28, 2025

Products & Programs PharmacyAnthem Blue Cross and Blue Shield | CommercialJuly 24, 2025

Specialty pharmacy updates — August 2025

Education & TrainingAnthem Blue Cross and Blue Shield | CommercialJuly 23, 2025

Reminder: Take action to protect infants from the respiratory syncytial virus this season

AdministrativeAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageJuly 23, 2025

Enhance care provider data accuracy with updated roster tools

Products & Programs PharmacyAnthem Blue Cross and Blue Shield | CommercialJuly 22, 2025

July formulary deletions

AdministrativeAnthem Blue Cross and Blue Shield | Medicare AdvantageJuly 21, 2025

Anthem Medicare Advantage Group Retiree Quick Reference Guide

Education & TrainingAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageJuly 18, 2025

New mandatory fields in roster template

Policy Updates Prior AuthorizationAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageJuly 1, 2025

Benefits of utilization management attestations: a guide for care providers

Policy Updates Reimbursement PoliciesAnthem Blue Cross and Blue Shield | CommercialJuly 1, 2025

Notice of material change/amendment to contract

New reimbursement policy: Code and Clinical Editing Guidelines — Professional and Facility

AdministrativeAnthem Blue Cross and Blue Shield | CommercialJuly 1, 2025

Access our updated provider manual for July 1, 2025, changes

Education & Training WebinarsAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageJuly 1, 2025

Join the 2025 Clinical Quality in Practice webinar series

Education & TrainingAnthem Blue Cross and Blue Shield | Medicare AdvantageJuly 1, 2025

Combat diabetes: Close the statin therapy gap for better heart health

AdministrativeAnthem Blue Cross and Blue Shield | CommercialJuly 1, 2025

Notice of material change/amendment to contract

Notices of material changes/amendments to contract — July 2025

Administrative Digital SolutionsAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageJuly 1, 2025

Streamlining behavioral health authorizations via Availity Essentials

AdministrativeAnthem Blue Cross and Blue Shield | CommercialJuly 1, 2025

Update: essential ICD‑10‑CM compliance for outpatient facility claims

Policy Updates Medical Policy & Clinical GuidelinesAnthem Blue Cross and Blue Shield | CommercialJuly 1, 2025

Notice of material change/amendment to contract

Medical Policy and Clinical Guideline updates

Policy Updates Prior AuthorizationAnthem Blue Cross and Blue Shield | CommercialJuly 1, 2025

Notice of material change/amendment to contract

Precertification/Prior Authorization list change notification July 1, 2025

Administrative Digital SolutionsAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageJuly 1, 2025

Seamless Provider Enrollment and Network Management through Availity Essentials optimizes the care provider experience

AdministrativeAnthem Blue Cross and Blue Shield | Medicare AdvantageJuly 1, 2025

A quick guide to understanding JW and JZ modifiers

AdministrativeAnthem Blue Cross and Blue Shield | CommercialJuly 1, 2025

A quick guide to understanding JW and JZ modifiers

AdministrativeAnthem Blue Cross and Blue Shield | Medicare AdvantageJuly 1, 2025

Implementation of chargemaster‑based claims edit for ER leveling

Policy Updates Reimbursement PoliciesAnthem Blue Cross and Blue Shield | CommercialJuly 1, 2025

Notice of material change/amendment to contract

Reimbursement policy update: Bundled Services and Supplies — Professional

AdministrativeAnthem Blue Cross and Blue Shield | CommercialJuly 1, 2025

Enroll with Availity to verify your provider data

Products & Programs PharmacyAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageJuly 1, 2025

Update: National Drug Codes (NDCs) are required for professional and outpatient claims

Products & Programs PharmacyAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageJune 27, 2025

Specialty pharmacy precertification list expanded

Effective November 1, 2025
Axtle, Bizengri, and Bynfezia pen

AdministrativeAnthem Blue Cross and Blue Shield | Medicare AdvantageJune 23, 2025

Essential information for providers: understanding Medicare Advantage group retiree plans

Administrative Digital SolutionsAnthem Blue Cross and Blue Shield | Medicare AdvantageJune 17, 2025

Specialty pharmacy precertification list expansion — key updates

Products & Programs PharmacyAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageJune 6, 2025

National Drug Codes (NDCs) are required for outpatient claims

Policy UpdatesAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageJune 2, 2025

Clinical Criteria updates

Effective July 6, 2025

Products & Programs PharmacyAnthem Blue Cross and Blue Shield | CommercialJune 2, 2025

Notice of material change/amendment to contract

Specialty pharmacy updates: June 2025

Education & TrainingAnthem Blue Cross and Blue Shield | CommercialJune 1, 2025

Availity Essentials Provider Overpayments application launch

Education & TrainingAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageJune 1, 2025

Claims guidance: updating inpatient and outpatient bill types

Education & Training WebinarsAnthem Blue Cross and Blue Shield | CommercialAnthem Blue Cross and Blue Shield | Medicare AdvantageJune 1, 2025

Registration is now available for our upcoming CME webinar on Integrating Cancer Care

Education & TrainingAnthem Blue Cross and Blue Shield | Medicare AdvantageJune 1, 2025

Bridging the gap: enhancing medication adherence for better health outcomes

Products & Programs PharmacyAnthem Blue Cross and Blue Shield | CommercialJune 1, 2025

Notice of material change/amendment to contract

Clinical Criteria updates for specialty pharmacy

AdministrativeAnthem Blue Cross and Blue Shield | CommercialJune 1, 2025

Update to claims system for global surgical procedures for professional providers