CommercialPrior AuthHigh impact
Select musculoskeletal procedure codes continue to require prior authorization through e-referral for FEP members, won’t move to TurningPoint
BCBS Michigan·MI · Orthopedics, Neurosurgery·Prior Authorization
Effective date
Jan 1, 2026
We identified it
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.
Action Required
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.