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CommercialPrior AuthMedium impact

MPC August 2025

Blue Cross Blue Shield of Nebraska·NE · Radiation Oncology, Orthopedics, Podiatry +2 more·Medical Policy
Effective date
Dec 1, 2025
We identified it
Jun 24, 2026
Days to comply

Summary

Blue Cross and Blue Shield of Nebraska now considers low dose radiation therapy for osteoarthritis and plantar fasciitis as not medically necessary. This policy requires preauthorization and becomes effective December 1, 2025.

Action Required

Action needed
By December 1, 2025: Billing team must update system to require prior authorization for all low dose radiation therapy claims for osteoarthritis and plantar fasciitis diagnoses. Update encounter forms to alert providers that BCBSNE considers these treatments not medically necessary. Claims without prior auth will be denied.