CommercialPrior AuthMedium impact
[Virginia] Precertification list change notification
Anthem BCBS·VA · Critical Care, Pulmonology, Cardiology +1 more·Provider Bulletin
Effective date
Oct 1, 2026
We identified it
Jun 17, 2026
Summary
Anthem Blue Cross and Blue Shield Virginia is adding Inhaled Nitric Oxide (CG-MED-69) to their precertification requirements effective October 1, 2026. This means prior authorization will be required before administering inhaled nitric oxide to commercial plan members, or claims may be denied.
Action Required
Before October 1, 2026: Billing team must update prior authorization workflows to require precertification for Inhaled Nitric Oxide services under criteria CG-MED-69 for Anthem BCBS Virginia commercial members. Verify member eligibility through Availity Essentials or call member ID card number before service. Failure to obtain precertification will result in claim denial.