Highlights

Key Updates

AdministrativeAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageSeptember 1, 2025

Elevate your workflow with seamless patient chart uploads

Education & TrainingAMH Health, LLC | Medicare AdvantageAugust 25, 2025

Enhance your skills with expanded billing and coding training


What's New

Recent Updates

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

Notice of material change/amendment to contract

Specialty pharmacy updates — September 2025

AdministrativeAnthem Blue Cross and Blue Shield | CommercialSeptember 1, 2025

Notice of material change/amendment to contract

Notices of material changes/amendments to contract — September 2025

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

Medication safety: Reducing risks with thoughtful prescribing and monitoring

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

Notice of material change/amendment to contract

Clinical Criteria updates for specialty pharmacy

Effective December 1, 2025

AdministrativeAnthem Blue Cross and Blue Shield | Medicare AdvantageAMH Health, LLC | Medicare AdvantageSeptember 1, 2025

Elevate your workflow with seamless patient chart uploads

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

Elevate your practice efficiency with electronic prescriber tools

Policy Updates Prior AuthorizationAnthem Blue Cross and Blue Shield | CommercialAugust 28, 2025

Notice of material change/amendment to contract

Carelon Medical Benefits Management, Inc. Additional Outpatient Utilization Management and Surgical

Effective December 1, 2025

Policy Updates Prior AuthorizationAnthem Blue Cross and Blue Shield | CommercialAugust 26, 2025

Notice of material change/amendment to contract

New guidelines for PET radiotracer management in UM beginning December 1, 2025

Education & TrainingAMH Health, LLC | Medicare AdvantageAugust 25, 2025

Enhance your skills with expanded billing and coding training

Products & Programs PharmacyAnthem Blue Cross and Blue Shield | Medicare AdvantageAugust 25, 2025

Anthem expands specialty pharmacy precertification lists

Effective December 1, 2025
Avtozma, Osenvelt, Osenvelt, Stoboclo, and Xbryk

Education & TrainingAnthem Blue Cross and Blue Shield | Medicare AdvantageAugust 21, 2025

Medication safety: Clinical strategies for EMR monitoring and prevention

Policy Updates Medical Policy & Clinical GuidelinesAnthem Blue Cross and Blue Shield | Medicare AdvantageAugust 14, 2025

Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness Guidelines

Effective November 15, 2025

Policy Updates Medical Policy & Clinical GuidelinesAnthem Blue Cross and Blue Shield | CommercialAugust 14, 2025

Notice of material change/amendment to contract

Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness Guidelines

Effective November 15, 2025

Policy Updates Prior AuthorizationAnthem Blue Cross and Blue Shield | Medicare AdvantageAugust 14, 2025

Precertification/prior authorization requirement changes

Effective December 1, 2025

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

Expanded specialty pharmacy precertification list

Effective November 1, 2025
Bomyntra, Conexxence, Imaav, Jobevne, Omlyclo, Qfitlia, Vyalev, and Jobevne

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

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

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

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

Introducing a new Applied Behavior Analysis Provider Resource Guide

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

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

AdministrativeAnthem Blue Cross and Blue Shield | CommercialJuly 1, 2025

Enroll with Availity to verify your provider data

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

AdministrativeAnthem Blue Cross and Blue Shield | CommercialJuly 1, 2025

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

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

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

A quick guide to understanding JW and JZ modifiers

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

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 | Medicare AdvantageJuly 1, 2025

Implementation of chargemaster‑based claims edit for ER leveling

AdministrativeAnthem Blue Cross and Blue Shield | CommercialJuly 1, 2025

A quick guide to understanding JW and JZ modifiers