Prior authorization requirement changes effective March 1, 2024 

Effective March 1, 2024, prior authorization (PA) requirements will change for the following code(s). The medical code(s) listed below will require PA by Anthem Blue Cross and Blue Shield for Medicare members. Federal and state law, as well as state contract language and Centers for Medicare & Medicaid Services guidelines, including definitions and specific contract provisions/exclusions take precedence over these precertification rules and must be considered first when determining coverage.

Non-compliance with new requirements may result in denied claims.

Prior authorization requirements will be added for the following code(s):

Not all PA requirements are listed here. Detailed PA requirements are available to providers by visiting Medicare Advantage Providers | Anthem.com > Providers > Claims> Prior Authorization, or for contracted providers by accessing Availity.com. Providers may also call number on the back of their patient’s member ID card for Provider Service for assistance with PA requirements.