Anthem – Prior Authorization Requirement Changes Effective July 1, 2024

Effective July 1, 2024, prior authorization (PA) requirements will change for the following code(s). The medical code(s) listed below will require PA by Anthem for Medicare Advantage 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):
0088U, 0342U, 0361U, 0390U, 0407U, 0412U, 0494T, 0495T, 64505

Source: https://providernews.anthem.com/colorado/articles/prior-authorization-requirement-changes-effective-july-1-202-3-18650