CommercialPrior AuthMedium impact
Prior Authorization Changes for Some Commercial and Government Program Members
BCBS Montana·MT · Radiology, Oncology·Prior Authorization
Effective date
Oct 1, 2026
We identified it
Jun 18, 2026
Summary
BCBS Montana is implementing new prior authorization requirements for commercial and government program members effective October 1, 2026. Transportation management codes will now require prior authorization and be reviewed by BCBSMT for commercial members, while select Proton Beam codes will require prior authorization for Medicare Advantage members.
Action Required
Before October 1, 2026: Billing team must update prior authorization workflows to obtain approval for transportation management codes (commercial members) and select Proton Beam codes (Medicare Advantage members) through BCBSMT. Review the revised code list referenced in the policy to identify specific codes requiring prior authorization. Update billing software and staff training accordingly.