Medicare AdvantagePrior AuthHigh impact
Important Updates to Medicare Part B Drug Prior Authorization HCPCS Codes
Florida Blue·FL·Prior Authorization
Effective date
Apr 1, 2026
We identified it
Jun 16, 2026
Summary
Florida Blue Medicare has updated their Medicare Part B Drug prior authorization HCPCS codes effective April 1, 2026. All codes included in claims must exactly match the authorized HCPCS codes or the authorization will be invalid and services will be denied.
Action Required
By April 1, 2026: Billing team must access the updated list of Medicare Part B Drug HCPCS codes requiring prior authorization from Florida Blue Medicare's website. Verify all prior authorization requests use the exact HCPCS codes that will be billed on claims. Update billing system edits to ensure code matching between authorizations and claims. Train staff that any mismatch between authorized codes and billed codes will result in claim denials.