← Back to list
[Georgia] National accounts: 2027 standard prior authorization requirements
Act
by Dec 15, 2026
Effective date
Jan 1, 2027
Identified
Oct 2, 2026
Summary
Anthem Blue Cross and Blue Shield is expanding prior authorization (PA) requirements effective January 1, 2027, for Georgia commercial accounts. The policy adds comprehensive PA requirements across multiple service categories including advanced diagnostic testing (genetic testing, liquid biopsy, whole genome sequencing), specialized DME/prosthetics (robotic devices, AAC devices, bone growth stimulation), gene replacement therapies, CAR T-cell immunotherapy treatments, and numerous surgical procedures. Billing teams must update systems to require PA for these newly-covered services to avoid claim denials.
Get alerts when payers change rules like this one
We check Anthem BCBS and other payers every day and email you when a change matches your specialty and state.
Get Anthem BCBS alertsPolicy Monitoring is free. No card required.
What to do
by Dec 15, 2026 · 8 steps
01Billing team must update the prior authorization workflow in the billing system to require PA submission for all services listed in this policy before claim submission.
02Audit current claim denials to identify services now requiring PA.
03Update billing software rules to flag encounters containing the newly-covered procedures/services/drugs listed.
04Communicate the new PA requirements to all providers, especially those in oncology, genetics, orthopedics, cardiology, neurology, transplant, and behavioral health specialties.
05Create a reference guide for front desk and clinical staff listing all services requiring pre-certification.
06Train billing staff on the expanded PA categories (genetic testing, gene therapies, CAR-T treatments, advanced DME, bariatric surgery, gender-affirming procedures, transplant services, MHSA services, and surgical procedures).
07Update intake forms to remind providers to obtain PA before scheduled procedures.
08Consequence: Claims submitted without required prior authorization for these services will be denied, resulting in revenue loss and patient responsibility issues.
Original notice
[Georgia] National accounts: 2027 standard prior authorization requirements
providernews.anthem.com · Always check the source before changing claims.
Related changes
See all Anthem BCBS changes →[Georgia] National accounts: 2027 standard prior authorization requirementsHighEffective Jan 1, 2027 · Provider Bulletin[California] National accounts: 2027 prior authorization requirementsMediumEffective Jan 1, 2027 · Provider Bulletin[Ohio] National accounts: 2027 standard prior authorization requirementsHighEffective Jan 1, 2027 · Provider Bulletin[Virginia] National accounts: 2027 standard prior authorization requirementsHighEffective Jan 1, 2027 · Provider BulletinBrowse every Anthem BCBS change in the policy list