This page includes the commercial prior authorization summaries and code lists that were posted as of the end of the year for the past two years.
2025
- Prior Authorization Procedure Codes List for Fully Insured Plans and Certain ASO Groups Effective Jan. 1, 2026 (Updated Oct. 1, 2025)
Prior Authorization Procedure Codes List for Other ASO Plans Effective Jan. 1, 2026 (Updated Oct. 1, 2025)
Prior Authorization Procedure Codes List for Other ASO Plans Effective Jan. 1, 2025
2024
- Prior Authorization Procedure Codes List for Fully Insured Plans and Certain ASO Groups Effective Jan. 1, 2024 − Dec. 31, 2024 (Includes changes effective Oct. 1, 2024)
Prior Authorization Procedure Codes List for Other ASO Plans Effective Jan. 1, 2024 - Dec. 31, 2024 (Includes changes effective Oct. 1, 2024)
Checking eligibility and benefits and/or obtaining prior authorization is not a guarantee of payment of benefits. Payment of benefits is subject to several factors, including, but not limited to, eligibility at the time of service, payment of premiums/contributions, amounts allowable for services, supporting medical documentation, and other terms, conditions, limitations, and exclusions set forth in the member’s policy certificate and/or benefits booklet and or summary plan description. Regardless of any prior authorization or benefit determination, the final decision regarding any treatment or service is between the patient and the health care provider. If you have any questions, call the number on the member's BCBSTX ID card.