Anthem precertification list change notification April 1, 2025

The following services will be added to precertification for the effective dates listed below.

Eligibility and benefits can be verified by accessing Availity Essentials at https://Availity.com or by calling the number on the back of the member’s identification card. Service precertification is based on the member’s benefit plan/eligibility at the time the service is reviewed/approved. Benefit plans vary widely and are subject to change based on the contract’s effective dates. The provider is responsible for the verification of member eligibility and covered benefits.

If the requirements are not met, those services may be deemed ineligible for payment. Providers may appeal online through Availity Essentials or phone Anthem Provider Services with additional information, which may include medical records.

Add to precertification
Criteria	Criteria description	Code	Effective date
CG-DME-10	Durable Medical Equipment	K0900	7/01/2025