CommercialPrior AuthMedium impact
[Georgia] Prior authorization requirement changes
Anthem BCBS·GA · General Practice, Wound Care, Physical Therapy +1 more·Provider Bulletin
Effective date
Jun 1, 2026
We identified it
May 20, 2026
Summary
Effective June 1, 2026, Anthem Blue Cross Blue Shield Georgia is adding compression devices for lymphedema and pneumatic compression devices for DVT prevention (HCPCS code E0658) to its prior authorization requirements. Billing teams must obtain prior authorization before billing this DME code for Georgia commercial members, or claims will be denied.
Action Required
By May 15, 2026: Billing team must update the billing system to require prior authorization for HCPCS code E0658 (compression devices for lymphedema and pneumatic compression devices for DVT prevention) for all Anthem Blue Cross Blue Shield Georgia commercial plans. Update DME order forms and provider templates to include prior authorization reminders. Verify member eligibility and benefits through Availity Essentials before submitting orders. Train front desk and billing staff to flag E0658 claims for prior auth submission. Claims submitted without prior authorization will be denied and may impact patient care and revenue.