Start free

PolicyChanges tracks payer policy changes for medical practices and tells you what to do before they take effect.

Create a free accountPolicy Monitoring is free. No card required.
← Back to list
Anthem BCBSCommercial · Prior Auth · Provider Bulletin · OHLow impact

[Ohio] Precertification/prior authorization requirement updates — Carelon Medical Benefits Management

Act
by Feb 1, 2027
Effective date
Feb 1, 2027
Identified
Oct 7, 2026

Summary

Effective February 1, 2027, Anthem Blue Cross and Blue Shield (Ohio) will require prior authorization/precertification for CPT code E0765 (FDA-approved nerve stimulator for nausea and vomiting treatment) through Carelon Medical Benefits Management. Providers must submit authorization requests via the Carelon provider portal, Availity Essentials, or email before delivering this service 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 Feb 1, 2027 · 3 steps
01Billing and clinical staff should implement prior authorization requirements for CPT code E0765 in the practice's billing system and provider workflows for Anthem Blue Cross and Blue Shield Ohio Commercial plans.
02Ordering providers and service providers must submit precertification requests to Carelon Medical Benefits Management via the provider portal (https://providerportal.com), Availity Essentials (https://Availity.com), or email (MedicalBenefitsManagement.guidelines@Carelon.com) before delivering the service.
03Claims for E0765 submitted without prior authorization will be subject to denial.

Codes mentioned

E0765

Original notice

[Ohio] Precertification/prior authorization requirement updates — Carelon Medical Benefits Management
providernews.anthem.com · Always check the source before changing claims.
View original ↗

Related changes

See all Anthem BCBS changes →
[Virginia] Precertification/prior authorization requirement updates — Carelon Medical Benefits ManagementMediumEffective Feb 1, 2027 · Provider Bulletin[New York] Precertification/prior authorization requirement updates — Carelon Medical Benefits ManagementMediumEffective Feb 1, 2027 · Provider Bulletin[Georgia] Precertification/prior authorization requirement updates — Carelon Medical Benefits ManagementMediumEffective Feb 1, 2027 · Provider Bulletin[New York] Precertification/prior authorization list change notificationMediumEffective May 1, 2026 · Provider BulletinBrowse every Anthem BCBS change in the policy list

Related policy hubs

Anthem BCBS policiesOH policy changesCode E0765

Summaries are AI-assisted. Always confirm against the original payer notice.

What is PolicyChanges

One workspace for payer rules, prior auth, coding and compliance

Medical practices use PolicyChanges to catch payer changes before they cause denials. Every change is summarized in plain English, with the codes involved, the date it takes effect and what to do.

Policy MonitoringPayer policy, prior auth and coding changes, filtered to your saved searchesOIG ScreeningStaff and vendors screened every month against OIG LEIE, SAM.gov and state Medicaid listsPrior Auth LookupKnow if a service needs prior authorization before you schedule itCredentialing TrackerLicenses, CAQH, Medicare revalidation and payer enrollments, with reminders before anything lapsesCompliance CenterKeep your HIPAA program documented and ready to show
Start freePolicy Monitoring is free. No card required.
Get alerts for changes like thisPolicy Monitoring is free. No card required.Create a free account