CommercialPrior AuthMedium impact
Authorization Updates - Effective September 1, 2026
Sentara Health Plans·VA · Allergy & Immunology, Family Medicine, General Practice +2 more·Prior Authorization
Effective date
Sep 1, 2026
We identified it
Aug 5, 2026
Summary
Effective September 1, 2026, Sentara Health Plans will no longer require prior authorization for four vaccine administration codes (90587, 90649, 90668, 90739) across all Commercial products in Virginia. Billing teams must update authorization workflows to remove these codes from prior auth requirements to prevent unnecessary claim delays.
Action Required
By September 1, 2026: Billing team must update the billing system to REMOVE prior authorization requirements for CPT codes 90587, 90649, 90668, and 90739 for all Sentara Health Plans Commercial products in Virginia. Update authorization rules in the EMR/billing software to flag these codes as "no prior auth required." Communicate change to providers and front desk staff so they stop requesting unnecessary authorizations. Failure to update rules may result in delayed processing or staff requesting authorizations that are no longer needed.