Policy UpdatesMedicaidOctober 2, 2024

Clarification to Carelon Medical Benefits Management, Inc. updates effective September 1, 2024

In the July 2024 edition of Provider News, we announced the transition to the following Carelon Medical Benefits Management guidelines: Site of Care for Advanced Imaging, Rehabilitative Site of Care, and Surgical Site of Care effective September 1, 2024. To clarify, existing prior authorization requirements have not changed, and this does not equate to the presence of a site of care review requirement. In the event a site of care review requirement for these services will be implemented, a separate notice will be distributed before the addition of any such requirements.

You may access and download a copy of the current and upcoming guidelines here:

  • Site of Care Guidelines:
    • Site of Care for Advanced Imaging
    • Rehabilitative Site of Care
    • Surgical Site of Care

Please share this notice with other members of your practice and office staff.

Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Blue Cross of California Partnership Plan, Inc. are independent licensees of the Blue Cross Association. Blue Cross of California is contracted with L.A. Care Health Plan to provide Medi-Cal Managed Care services in Los Angeles County. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

CABC-CD-067584-24-CPN67275

PUBLICATIONS: November 2024 Provider Newsletter