Medicare AdvantagePrior AuthHigh impact
Important Updates to Medicare Part B Drug Prior Authorization HCPCS Codes
Florida Blue·FL·Prior Authorization
Effective date
Sep 1, 2025
We identified it
Jun 16, 2026
Summary
Florida Blue Medicare updated their Medicare Part B Drug prior authorization HCPCS codes effective September 1, 2025. All HCPCS codes on claims must exactly match the authorized codes or the authorization will be invalid and services will be denied.
Action Required
Immediately: Billing team must access the updated Medicare Part B Drug Prior Authorization HCPCS codes list from Florida Blue Medicare and verify all Part B drug claims use exact HCPCS codes that match the authorization. Update billing system validation rules to prevent submission of claims with mismatched codes. Failure to match authorized codes will result in claim denials.