OSP News

Blue Cross Complete Updates Prior Authorization Requirements

Posted: 03/03/2024

This notice is a correction to the MCG alert dated Feb. 14, 2024, which incorrectly stated the effective date as June 1, 2024.

Beginning May 1, 2024, Blue Cross Complete is removing or reducing prior authorization requirements in several categories. Below is a summary of these changes by category, totaling 250 codes impacted by these changes.

Removal of the prior authorization and medical necessity review for these services is part of Blue Cross Complete PA Reduction’s continued dedication to supporting providers in their shared commitment to high quality health care for participants.

As a reminder, when you do need to verify whether a service requires prior authorization, use the Prior Authorization Lookup Tool at mibluecrosscomplete.com, you can also to read the Prior Authorization Requirement Updates. Please remember, the results of this tool are not a guarantee of coverage or authorization.

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