Carelon Medical Benefits Management, Inc. updates

Effective June 15, 2025, the following Carelon Medical Benefits Management Clinical Appropriateness Guideline updates will be adopted for Anthem. This article is to communicate the plan adoption of these guidelines. Existing preapproval requirements have not changed. In the event of implementation of a preapproval requirement for these services, a separate notice will be distributed before the addition of preapproval requirements.

The following guideline updates have a publish date of 6/15/2025:

• Genetic Testing:
• Chromosomal Microarray Analysis
• Pharmacogenomic Testing
• Whole Exome Sequencing and Whole Genome Sequencing
• Musculoskeletal:
• Interventional Pain Management

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

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