Carelon Medical Benefits Management, Inc. updates - November 2023

Effective for dates of service on and after November 5, 2023, the following updates will apply to the Carelon Medical Benefits Management, Inc. Clinical Appropriateness Guidelines for medical necessity review for AMH Health, LLC:

• Musculoskeletal Guidelines:
  • Small Joint Surgery

Existing precertification requirements have not changed. Share this notice with other members of your practice and office staff.

Through our efforts, we can help our care provider partners deliver high quality, equitable healthcare.