CommercialPrior AuthMedium impact
Buprenorphine
Blue Cross & Blue Shield of Mississippi·MS · Psychiatry, Pain Management, Family Medicine +1 more·Medical Policy
We identified it
Jun 20, 2026
Summary
Blue Cross Blue Shield of Mississippi updated their buprenorphine policy requiring prior authorization for Subutex (buprenorphine) sublingual tablets and declaring Sublocade injections not medically necessary. The policy includes specific criteria for initial approval and 12-month renewals for opioid dependence treatment.
Action Required
Immediately: Billing team must ensure prior authorization is obtained before prescribing or billing for Subutex (buprenorphine) sublingual tablets. Update system to flag that Sublocade (buprenorphine extended-release) injections are not covered and will be denied. Providers must document treatment plans including counseling/psychosocial support and verify patients meet age and indication criteria before submitting prior auth requests.