Policy Updates Prior AuthorizationMedicare AdvantageMarch 27, 2025

Outpatient preapproval update from Carelon Medical Benefits Management, Inc.

Effective for dates of service on and after July 1, 2025, the following non-emergency transportation code requires preapproval through Carelon Medical Benefits Management.

CPT® code

Description

A0425

Ground mileage, per statute mile

As a reminder, ordering and servicing providers may submit preapproval requests to Carelon Medical Benefits Management in one of several ways:

  • Visit Carelon Medical Benefits Management’s providerportal.com:
    • Online access is available 24/7 to process orders in real‑time and is the fastest and most convenient way to request authorization.
  • Access via https://Availity.com.

If you have questions, please contact Carelon Medical Benefits Management via email at MedicalBenefitsManagement.guidelines@Carelon.com or visit https://guidelines.carelonmedicalbenefitsmanagement.com.

Blue Medicare Advantage is the trade name of Group Retiree Health Solutions, Inc., an independent licensee of the Blue Cross Blue Shield Association.

PAIBC-CR-078791-25-CPN77989