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Anthem BCBSCommercial · Prior Auth · Provider Bulletin · VA · Ophthalmology, Orthopedics, PM&R (Physical Medicine & Rehab) +2 moreMedium impact

[Virginia] Precertification/prior authorization list change notification

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

Summary

Effective May 1, 2026, Anthem Blue Cross Blue Shield Virginia is adding four new services to its precertification/prior authorization requirement list: PFAS testing (0589U), electrical stimulation devices (E0765), allogeneic bone marrow-derived mesenchymal stromal cell therapy (J3402), and encapsulated cell therapy for degenerative ocular disease (J3403). Providers must obtain prior authorization before delivering these services or claims may be denied for ineligibility.

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What to do

by Apr 1, 2026 · 4 steps
01Billing team must update billing software and prior authorization workflows to require precertification for CPT 0589U (PFAS testing), HCPCS E0765 (electrical stimulation devices), and HCPCS J3402 and J3403 (cell therapies).
02Providers and clinical staff must be notified to obtain prior authorization through Availity Essentials or by calling the member ID card number before rendering these services.
03Update encounter forms and pre-service checklists to flag these codes.
04Update provider education materials with new authorization requirements and contact information (800-755-0851 for mental health/substance use precertification).
If missed: Failure to obtain required prior authorization will result in claim denials and service ineligibility.

Codes mentioned

E0765J3402J3403

Original notice

[Virginia] 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[Georgia] 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 policiesVA policy changesOphthalmologyOrthopedicsPM&R (Physical Medicine & Rehab)Pain ManagementNeurologyCode E0765Code J3402Code J3403

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