CommercialPrior AuthMedium impact
[Virginia] Precertification/prior authorization list change notification
Anthem BCBS·VA · Wound Care, Physical Therapy, General Practice·Provider Bulletin
Effective date
Dec 1, 2026
We identified it
Aug 14, 2026
Summary
Effective December 1, 2026, Anthem Blue Cross and Blue Shield in Virginia is adding compression devices for lymphedema (HCPCS code E0659) to its precertification/prior authorization requirements. Providers must obtain prior authorization before rendering this service or claims may be denied as ineligible for payment.
Action Required
By November 15, 2026: Billing team must update the billing system to require prior authorization for HCPCS code E0659 (compression devices for lymphedema) for all Anthem Blue Cross and Blue Shield and HealthKeepers commercial plans in Virginia. Providers must be notified to request precertification/prior authorization through Availity Essentials or by calling the member ID card number before dispensing compression devices. Failure to obtain prior authorization will result in claim denials and services being deemed ineligible for payment.