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.

Anthem Blue Cross and Blue Shield is the trade name of Blue Cross Blue Shield of Wisconsin (BCBSWI), Compcare Health Services Insurance Corporation (Compcare), and Wisconsin Collaborative Insurance Company (WCIC). BCBSWI underwrites or administers PPO and indemnity policies and underwrites the out of network benefits in POS policies offered by Compcare or WCIC; Compcare underwrites or administers HMO or POS policies; WCIC underwrites or administers Well Priority HMO or POS policies. Independent licensee(s) of the Blue Cross Blue Shield Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.

MULTI-BCBS-CR-078792-25-CPN77989

PUBLICATIONS: April 2025 Provider Newsletter