All PlansPrior AuthMedium impact
Availity Essentials Update: Authorization Submissions for Inpatient Services
Florida Blue·FL·Prior Authorization
Effective date
Aug 16, 2025
We identified it
Jun 16, 2026
Summary
Starting August 16, 2025, Availity Essentials will streamline inpatient authorization submissions by moving Admission Type and Service Type fields to the beginning and only requiring procedure codes for certain services. Emergency, Skilled Nursing, Rehabilitation, and Long-Term Care inpatient services will no longer require procedure codes, while all other inpatient services will still require them.
Action Required
Before August 16, 2025: Billing team must train staff on the new Availity Essentials workflow where Admission Type and Service Type fields appear first in inpatient authorization submissions. Update internal procedures to reflect that Emergency Services, Skilled Nursing Care, Rehabilitation, and Long-Term Care inpatient services no longer require procedure codes, while all other inpatient services will still require them. Note that outpatient services remain unchanged and continue to require procedure codes.