Medicare AdvantagePrior AuthMedium impact
[New York] Precertification/prior authorization requirement changes
Anthem BCBS·IN, NY · Cardiology, Internal Medicine·Provider Bulletin
Effective date
Nov 1, 2026
We identified it
Jul 21, 2026
Summary
Effective November 1, 2026, Anthem Medicare Advantage plans in Indiana and New York will require prior authorization for CPT 93356 (myocardial strain imaging using speckle tracking). Billing teams must obtain precertification before performing this service or claims will be denied as ineligible for payment.
Action Required
By October 31, 2026: Billing team must update billing software and encounter forms to require prior authorization from Anthem before performing CPT 93356 for Medicare Advantage members in Indiana and New York. Flag this code in the system as requiring precertification before submission. Providers should verify authorization through Availity Essentials or by contacting Anthem Provider Services. Failure to obtain prior authorization will result in claim denials and services being deemed ineligible for payment. Reference UM AROW # A2026M5634 when requesting authorization.