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Medicare AdvantagePrior AuthMedium impact

[Georgia] Precertification/prior authorization requirement changes

Anthem BCBS·GA · Cardiology·Provider Bulletin
Effective date
Nov 1, 2026
We identified it
Jul 21, 2026
Days to comply
102 days

Summary

Effective November 1, 2026, Anthem Blue Cross Blue Shield Medicare Advantage plans in Georgia will require prior authorization for CPT code 93356 (myocardial strain imaging using speckle tracking). Providers must obtain precertification before billing this service or claims will be denied as ineligible for payment.

Action Required

Before Nov 1, 2026
By October 31, 2026: Billing team must update billing software and encounter forms to require prior authorization for CPT 93356 when billed to Anthem Medicare Advantage Georgia members. Establish workflow to submit precertification requests through Availity Essentials or by phone to Provider Services before service delivery. Train cardiology providers and clinical staff on the new requirement. Claims submitted without prior authorization will be denied as ineligible for payment. Providers may appeal denials with additional medical records and clinical documentation through Availity or Provider Services.

Affected Billing Codes

93356