Medicare AdvantagePrior AuthMedium impact
[California] Precertification/prior authorization requirement changes
Anthem BCBS·CA · Cardiology, Internal Medicine·Provider Bulletin
Effective date
Nov 1, 2026
We identified it
Jul 21, 2026
Summary
Effective November 1, 2026, Anthem Blue Cross Medicare Advantage plans in California will require precertification/prior authorization for CPT 93356 (myocardial strain imaging using speckle tracking). Billing teams must implement prior auth requirements in their systems and encounter workflows for this cardiac imaging code to avoid claim denials.
Action Required
By October 31, 2026: Billing team must update billing software and claim submission workflows to require prior authorization from Anthem Blue Cross for CPT 93356 before services are rendered. Providers performing cardiac echocardiography with speckle tracking assessments must obtain precertification through Availity Essentials or by calling Anthem Provider Services. Update encounter forms and clinical templates to include a reminder that prior auth is required for this code. Train front desk and clinical staff to flag CPT 93356 orders for prior auth submission. Claims submitted without required prior authorization will be denied for Medicare Advantage members (Medicare PPOs, D-SNPs, ISNPs, and CSNPs) in California. Providers may appeal denials online through Availity or by phone with supporting medical records.