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 Blue Cross Medicare AdvantageSM Prior Authorization Requirement List
- Effective Oct. 1, 2025
- Effective April 1, 2025 - Sept. 30, 2025
- Effective Jan. 1, 2025 - Mar. 31, 2025
2024 Blue Cross Medicare AdvantageSM Prior Authorization Requirement List
Effective Jan. 1, 2024 - Dec. 31, 2024 (Includes changes effective Oct. 1, 2024)
2025 Blue Cross Medicare Advantage Procedure Code List
- Effective Oct. 1, 2025
- Effective July 1, 2025 - Sept. 30, 2025
- Effective April 1, 2025 - June 30, 2025
- Effective Jan. 1, 2025 - Mar, 31, 2025
2024 Blue Cross Medicare Advantage Procedure Code List
- Effective Jan. 1, 2024 - Dec. 31, 2024 (Includes changes effective Oct. 1, 2024)
2025 Blue Cross Medicare Advantage Procedure Code List Change Summary
- Effective Oct. 10, 2025
- Effective April 1, 2025 - Sept. 30, 2025 Effective April 1, 2025 - Sept. 30, 2025
- Effective Jan. 1, 2025 - Mar. 31, 2025 Effective Jan. 1, 2025 - March 31, 2025
2024 Blue Cross Medicare Advantage Procedure Code List Change Summary
- 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.