All PlansCoverageMedium impact
Upcoming Policies effective December 1, 2025
Blue Cross and Blue Shield of Minnesota·MN · Cardiology, Cardiothoracic Surgery, Hematology +1 more·Medical Policy
Effective date
Dec 1, 2025
We identified it
Jun 20, 2026
Summary
Blue Cross MN has updated three medical policies effective December 1, 2025: transcatheter tricuspid valve procedures are now considered experimental/investigative, revised general medical necessity criteria for technologies without specific policies, and updated coverage criteria for hematopoietic stem cell transplantation in acute lymphoblastic leukemia patients.
Action Required
By December 1, 2025: Review and update prior authorization processes for transcatheter tricuspid valve procedures (now experimental/investigative) and hematopoietic stem cell transplantation claims. Clinical team must ensure all medical necessity documentation meets the revised criteria outlined in policy XI-02. Update encounter forms and billing system notes to reflect new experimental status for tricuspid valve procedures and updated ALL treatment criteria.