92549 Insurance Policy Changes

Experimental-Investigational Services

Blue Cross Blue Shield of Arizona has issued a new Evidence-Based Criteria policy (effective 11/01/26) that classifies 62 specific CPT and HCPCS codes as experimental or investigational services and therefore non-covered. This policy applies broadly across multiple specialties and requires billing teams to deny claims for these codes unless members have explicit coverage for experimental services in their benefit plans.