By September 1, 2026: Billing team must update billing software to require prior authorization through Carelon Medical Benefits Management for all 30 affected CPT/HCPCS codes (0913T, 0914T, 0523U, 0529U, 0530U, 81195, 81558, 0439U, 0440U, 0444U, 0448U, 0449U, 0452U, 0453U, 0454U, 0456U, 0460U, 0461U, 0465U, 0466U, 0467U, 0469U, 0471U, 0473U, 0474U, 0475U, 0020M, 0476U, 0477U, 0478U) for New York Medicaid claims with dates of service on or after October 1, 2026. Providers and billing staff must be notified of these requirements. Add these codes to prior authorization workflows and encounter templates. Clinical staff should initiate prior auth requests before ordering these tests or procedures. Claims submitted without prior authorization will be denied by Carelon.