CommercialPrior AuthMedium impact
Provider Notification March 2025
Blue Cross Blue Shield of Nebraska·NE · Psychiatry, Neurology·Medical Policy
Effective date
Jun 15, 2025
We identified it
Jun 24, 2026
Summary
Blue Cross Blue Shield of Nebraska is updating medical policies for Transcranial Magnetic Stimulation (TMS) and Electroconvulsive Therapy (ECT), requiring preauthorization using InterQual criteria effective June 15, 2025. Both procedures will need prior authorization approval before services can be rendered.
Action Required
By June 15, 2025: Billing team must update systems to require prior authorization for all TMS and ECT procedures for BCBSNE members. Review InterQual criteria on the BCBSNE Provider Procedures page website. Ensure staff obtains preauthorization before scheduling these procedures to avoid claim denials.