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Upcoming Policies effective January 5, 2026
Blue Cross and Blue Shield of Minnesota·Endocrinology, Oncology, Hematology·Medical Policy
Effective date
Jan 5, 2026
We identified it
Jun 20, 2026
Summary
Blue Cross MN revised medical necessity criteria for Continuous Glucose Monitoring (CGM) systems and Hematopoietic Stem Cell Transplantation policies. The changes specify new coverage requirements for professional, personal, and closed-loop CGM systems for diabetes patients, and updated transplantation criteria for acute myeloid leukemia, multiple myeloma, and POEMS syndrome.
Action Required
By January 5, 2026: Billing team must review and update prior authorization workflows for CGM systems and stem cell transplantation procedures to align with new medical necessity criteria. Update internal documentation requirements to verify patients meet the specific criteria outlined for Type 1 diabetes, insulin-dependent Type 2 diabetes, and transplantation indications. Train staff on new coverage limitations to prevent claim denials.