CommercialPrior AuthMedium impact
Cochlear Implants Policy Now Requires Prior Authorization
CareFirst BlueCross BlueShield·ENT (Ear, Nose & Throat), Neurosurgery·Prior Authorization
Effective date
Oct 1, 2023
We identified it
Jun 20, 2026
Summary
CareFirst BlueCross BlueShield will require prior authorization for all cochlear implant procedures and related equipment effective October 1, 2023. This affects one CPT code and five HCPCS codes for cochlear implantation services and devices across all commercial lines of business (excluding FEP).
Action Required
By October 1, 2023: Billing team must update system to require prior authorization for CPT 69930 and HCPCS codes L8614, L8619, L8628, L8681, L8690, L8691 for all CareFirst commercial plans. Update encounter forms and EMR templates to alert providers. Review CareFirst's Durable Medical Equipment Prior Authorization PDF and complete authorization training in their Learning and Engagement Center. Claims will be denied without proper prior authorization.