Policy Updates Prior AuthorizationMedicare AdvantageMarch 28, 2025

Outpatient preapproval update from Carelon Medical Benefits Management, Inc.

Effective for dates of service on and after July 1, 2025, the following non-emergency transportation code requires preapproval through Carelon Medical Benefits Management.

CPT® code

Description

A0425

Ground mileage, per statute mile

As a reminder, ordering and servicing providers may submit preapproval requests to Carelon Medical Benefits Management in one of several ways:

  • Visit Carelon Medical Benefits Management’s providerportal.com:
    • Online access is available 24/7 to process orders in real‑time and is the fastest and most convenient way to request authorization.
  • Access via https://Availity.com.

If you have questions, please contact Carelon Medical Benefits Management via email at MedicalBenefitsManagement.guidelines@Carelon.com or visit https://guidelines.carelonmedicalbenefitsmanagement.com.

Anthem BC Health Insurance Company is the trade name of Anthem Insurance Companies, Inc. Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross, Anthem Blue Cross Life and Health Insurance Company, and Anthem BC Health Insurance Company are independent licensees of the Blue Cross Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

CABC-CR-078790-25-CPN77989

PUBLICATIONS: April 2025 Provider Newsletter