CommercialPrior AuthMedium impact
[Georgia] Precertification/prior authorization list change notification
Anthem BCBS·GA · Ophthalmology, Optometry, Pediatrics·Provider Bulletin
Effective date
Jan 1, 2027
We identified it
Sep 10, 2026
Summary
Effective January 1, 2027, Anthem Blue Cross and Blue Shield in Georgia is adding five CPT codes (0687T, 0688T, 0704T, 0705T, 0706T) and one HCPCS code (A9292) for Dichoptic Digital Therapy for Amblyopia to their precertification/prior authorization requirements under clinical criteria CG-MED-102. All services using these codes will require prior authorization before delivery to avoid claim denials.
Action Required
By December 31, 2026: Billing team must update billing system to require prior authorization for CPT codes 0687T, 0688T, 0704T, 0705T, 0706T and HCPCS code A9292 when billed to Anthem Blue Cross and Blue Shield Georgia commercial plans. Update encounter forms and provider documentation templates to notify providers that Dichoptic Digital Therapy for Amblyopia now requires precertification before service delivery. Implement a workflow reminder to staff processing these codes to submit prior authorization requests using criteria CG-MED-102. Verify member eligibility and benefits through Availity Essentials or by calling the member ID card phone number before scheduling. Communicate the change to all clinical staff delivering these services. Claims submitted without prior authorization will be denied for payment.