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Anthem BCBSCommercial · Prior Auth · Provider Bulletin · GA · Pain Management, Ophthalmology, Oncology +2 moreMedium impact

[Georgia] Precertification/prior authorization list change notification

Act
by Apr 15, 2026
Effective date
May 1, 2026
Identified
May 18, 2026

Summary

Effective May 1, 2026, Anthem Blue Cross Blue Shield Georgia is adding four new services to its precertification/prior authorization requirement list for commercial plans: PFAS testing (0589U), electrical stimulation devices for pain (E0765), allogeneic bone marrow-derived mesenchymal stromal cell therapy (J3402), and encapsulated cell therapy for degenerative ocular disease (J3403). Billing teams must update systems to require prior authorization for these codes before claims are submitted.

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What to do

by Apr 15, 2026 · 4 steps
01Billing team must update the billing system and prior authorization workflow to require precertification/prior authorization for codes 0589U, E0765, J3402, and J3403 for all Anthem Blue Cross Blue Shield Georgia commercial plan members.
02Add these codes to the automated prior auth checking rules in the billing software.
03Update encounter forms and provider alerts to notify clinicians that these services require prior authorization before delivery.
04Verify member eligibility and benefits through Availity (https://availity.com) or by calling the member's insurance card number before scheduling or billing.
If missed: Failure to obtain prior authorization before service delivery may result in claim denials and loss of reimbursement.

Codes mentioned

E0765J3402J3403

Original notice

[Georgia] Precertification/prior authorization list change notification
providernews.anthem.com · Always check the source before changing claims.
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Related changes

See all Anthem BCBS changes →
[New York] Precertification/prior authorization list change notificationMediumEffective May 1, 2026 · Provider Bulletin[Virginia] Precertification/prior authorization list change notificationMediumEffective May 1, 2026 · Provider Bulletin[California] Prior authorization requirement changesMediumEffective May 1, 2026 · Provider Bulletin[Georgia] Precertification/prior authorization requirement changesMediumEffective May 1, 2026 · Provider BulletinBrowse every Anthem BCBS change in the policy list

Related policy hubs

Anthem BCBS policiesGA policy changesPain ManagementOphthalmologyOncologyPathologyGeneral PracticeCode E0765Code J3402Code J3403

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