Medicare AdvantagePrior AuthMedium impact
[Ohio] Precertification/prior authorization requirement changes
Anthem BCBS·OH · Cardiology·Provider Bulletin
Effective date
Nov 1, 2026
We identified it
Jul 21, 2026
Summary
Effective November 1, 2026, Anthem Blue Cross and Blue Shield will require prior authorization for CPT code 93356 (myocardial strain imaging using speckle tracking) for all Medicare Advantage and Fully Integrated Dual Eligible (FIDE) plans in Ohio. Services performed without prior authorization may be denied for payment.
Action Required
By October 31, 2026: Billing team must update billing system and encounter templates to require prior authorization for CPT 93356 when submitted to Anthem Medicare Advantage or FIDE plans in Ohio. Train providers and front desk staff to request prior auth from Anthem before scheduling or performing myocardial strain imaging studies. Establish workflow to obtain precertification through Availity Essentials or by calling Anthem Provider Services. Claims submitted without prior authorization will be denied payment. Update superbill templates and EMR order entry to flag this requirement for cardiology/echocardiography services.