November 2023

Starting Jan.1, prior authorization no longer required for some procedures

For dates of service on or after Jan. 1, 2024, the following procedures will no longer require prior authorization.

Note: For dates of service before Jan. 1, these procedures require prior authorization by Medicare Plus Blue℠ and BCN Utilization Management.

Procedure	Applies to	Affected procedure codes
Biofeedback, non-behavioral health	BCN commercial BCN Advantage℠	90901, 90912
Deep brain stimulation	Medicare Plus Blue BCN commercial BCN Advantage	61863, 61864, 61867, 61868, 61880, 61885, 61886, 61888
Noncoronary vascular stents	Medicare Plus Blue BCN commercial BCN Advantage	37236, 37238
Total artificial heart	BCN commercial BCN Advantage	0051T, 0052T, 0053T, 33927, 33928, 33975, 33976, 33977, 33978, 33979, 33980, 33981, 33982, 33983, 33990, 33991, 33992, 33993, 33995, 33997

Prior to Jan. 1, we’ll update lists of procedure codes that require prior authorization.

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*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2022 American Medical Association. All rights reserved.