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PAYER POLICY CHANGES

87551 Insurance Policy Changes

CPT 87551 is referenced in 2 tracked payer policy changes from Regence BlueShield and Blue Cross & Blue Shield of Mississippi. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 87551 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

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REFERENCE DATA

Payers with rules2
Payers requiring prior auth2
  • Anthem BCBS · Effective September 1, 2026

    Prior authorization required in some cases

    Virginia Local Precertification/Prior Authorization List (HMO & EPO)

  • Florida Blue · Effective March 27, 2026

    Prior authorization required

    Prior Authorization List: HMO – Marketplace Qualified Health Plans

FREQUENTLY ASKED QUESTIONS

Does Anthem BCBS require prior authorization for 87551?

Anthem BCBS lists 87551 on Virginia Local Precertification/Prior Authorization List (HMO & EPO) for commercial plans, with conditions (list dated September 1, 2026). Verify with the payer before scheduling.

Does Florida Blue require prior authorization for 87551?

Florida Blue lists 87551 on Prior Authorization List: HMO – Marketplace Qualified Health Plans for exchange plans (list dated March 27, 2026). Verify with the payer before scheduling.

What insurance policy changes affect CPT 87551?

There are 2 tracked policy changes affecting CPT 87551, including updates from Regence BlueShield, Blue Cross & Blue Shield of Mississippi. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for CPT 87551?

Payers that have issued tracked updates for CPT 87551 include: Regence BlueShield, Blue Cross & Blue Shield of Mississippi.

How do I get notified when CPT 87551 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to CPT 87551. You will get an email when new policy changes reference this code: daily or weekly, your choice, on every plan.

Why do payers change policies for CPT 87551?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

See every payer rule for 87551

Prior authorization lists, coverage criteria, NCCI edits and Medicare coverage articles for 87551 in one place.

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