Radiation oncology and radiopharmaceutical procedure codes to be managed through the Oncology Value Management program

By August 31, 2026: Billing team must immediately update all billing workflows and systems to route radiation oncology claims (CPT codes 55875-79101, C1716-C2616, G0339-G0458) and radiopharmaceutical claims (A9513, A9606, A9607) to OncoHealth for prior authorization instead of current vendors (EviCore/Carelon). Update internal documentation with OncoHealth contact information (1-888-916-2616) and OneUM portal access. Reconfigure billing software to require prior authorization for all affected codes for Blue Cross Blue Shield of Michigan, Blue Care Network commercial, Medicare Plus Blue, and BCN Advantage members receiving services in Michigan or other states. For members currently in active therapy on September 1, 2026: allow continuation at current location through August 31, 2027 (then apply site-of-care requirements starting September 1, 2027). Remove prior authorization routing to EviCore and Carelon for these codes on the effective date. Train all billing and authorizations staff on new OncoHealth submission requirements. Failure to route claims to OncoHealth will result in claim denials and delays. Exception: Do not apply to MESSA members or self-funded groups that have opted out (verify against opt-out list).