Who is affected by this change?

This affects BCBS Michigan Orthopedics, Neurosurgery providers in MI on Commercial plans.

When does this change take effect?

This change is effective Jan 1, 2026.

BCBS MichiganCommercial · Prior Auth · Prior Authorization · MI · Orthopedics, NeurosurgeryHigh impact

Select musculoskeletal procedure codes continue to require prior authorization through e-referral for FEP members, won’t move to TurningPoint

Q: What do I need to do?

Immediately: Continue submitting prior authorization requests through e-referral system for all listed musculoskeletal procedure codes for FEP commercial plan members. Do NOT submit these requests to TurningPoint Healthcare Solutions despite previous announcements. Update billing workflow to ensure all hip, knee, and spinal procedures require prior auth through e-referral before scheduling. Note this does not apply to Blue Care Network members whose prior auths remain with TurningPoint.

Q: Which billing codes are affected?

The following codes are affected: 27125, 27130, 27437, 27438, 27440, 27441, 27442, 27443, 27445, 27446, 27447, 22532, 22533, 22534, 22548, 22551, 22552, 22554, 22556, 22558, 22585, 22586, 22590, 22595, 22600, 22610, 22612, 22614, 22630, 22632, 22633, 22634, 22800, 22802, 22804, 22808, 22810, 22812, 22818, 22819, 22856, 22857, 22867, 22869, 63001, 63003, 63005, 63011, 63012, 63015, 63016, 63017, 63020, 63030, 63032, 63040, 63042, 63043, 63044, 63045, 63046, 63047, 63050, 63051, 63052, 63055, 63056, 63064, 63075, 63077, 63081, 63085, 63087, 63090, 63101, 63102, 63170, 63172, 63173, 63185, 63190, 63191, 63197, 63200, 63250, 63251, 63252, 63265, 63266, 63267, 63268, 63270, 63271, 63272, 63273, 63275, 63276, 63277, 63278, 63280, 63281, 63282, 63283, 63285, 63286, 63287, 63290, 63300, 63301, 63302, 63303, 63304, 63305, 63306, 63307.

Act

immediately

Effective date

Jan 1, 2026

Identified

Jun 16, 2026

Summary

For Blue Cross Blue Shield Federal Employee Program (FEP) members with commercial plans, prior authorization continues to be required through e-referral for select musculoskeletal procedures including hip, knee, and spinal surgeries effective January 1, 2026. These procedures will NOT move to TurningPoint Healthcare Solutions as previously announced.

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What to do

immediately · 4 steps

01Continue submitting prior authorization requests through e-referral system for all listed musculoskeletal procedure codes for FEP commercial plan members.

02Do NOT submit these requests to TurningPoint Healthcare Solutions despite previous announcements.

03Update billing workflow to ensure all hip, knee, and spinal procedures require prior auth through e-referral before scheduling.

04Note this does not apply to Blue Care Network members whose prior auths remain with TurningPoint.

Codes mentioned

27125271302743727438274402744127442274432744527446274472253222533225342254822551225522255422556225582258522586225902259522600226102261222614226302263222633226342280022802228042280822810228122281822819228562285722867228696300163003630056301163012630156301663017630206303063032630406304263043630446304563046630476305063051630526305563056630646307563077630816308563087630906310163102631706317263173631856319063191631976320063250632516325263265632666326763268632706327163272632736327563276632776327863280632816328263283632856328663287632906330063301633026330363304633056330663307

Original notice

Select musculoskeletal procedure codes continue to require prior authorization through e-referral for FEP members, won’t move to TurningPoint

bcbsm.com · Always check the source before changing claims.

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Related changes

See all BCBS Michigan changes →

Musculoskeletal procedures may require prior authorization through TurningPoint for FEP membersMediumNo effective date · Prior Authorization Browse every BCBS Michigan change in the policy list

Related policy hubs

BCBS Michigan policies MI policy changes Orthopedics Neurosurgery Code 27125 Code 27130 Code 27437 Code 27438 Code 27440 Code 27441 Code 27442 Code 27443 Code 27445 Code 27446 Code 27447 Code 22532 Code 22533 Code 22534 Code 22548 Code 22551 Code 22552 Code 22554 Code 22556 Code 22558 Code 22585 Code 22586 Code 22590 Code 22595 Code 22600 Code 22610 Code 22612 Code 22614 Code 22630 Code 22632 Code 22633 Code 22634 Code 22800 Code 22802 Code 22804 Code 22808 Code 22810 Code 22812 Code 22818 Code 22819 Code 22856 Code 22857 Code 22867 Code 22869 Code 63001 Code 63003 Code 63005 Code 63011 Code 63012 Code 63015 Code 63016 Code 63017 Code 63020 Code 63030 Code 63032 Code 63040 Code 63042 Code 63043 Code 63044 Code 63045 Code 63046 Code 63047 Code 63050 Code 63051 Code 63052 Code 63055 Code 63056 Code 63064 Code 63075 Code 63077 Code 63081 Code 63085 Code 63087 Code 63090 Code 63101 Code 63102 Code 63170 Code 63172 Code 63173 Code 63185 Code 63190 Code 63191 Code 63197 Code 63200 Code 63250 Code 63251 Code 63252 Code 63265 Code 63266 Code 63267 Code 63268 Code 63270 Code 63271 Code 63272 Code 63273 Code 63275 Code 63276 Code 63277 Code 63278 Code 63280 Code 63281 Code 63282 Code 63283 Code 63285 Code 63286 Code 63287 Code 63290 Code 63300 Code 63301 Code 63302 Code 63303 Code 63304 Code 63305 Code 63306 Code 63307

Select musculoskeletal procedure codes continue to require prior authorization through e-referral for FEP members, won’t move to TurningPoint

Summary

Get alerts when payers change rules like this one

What to do

Codes mentioned

Original notice

Related changes

Related policy hubs

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