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[Virginia] Precertification/prior authorization requirement updates — Carelon Medical Benefits Management
Act
by Feb 1, 2027
Effective date
Feb 1, 2027
Identified
Oct 10, 2026
Summary
Effective February 1, 2027, Anthem Blue Cross and Blue Shield in Virginia is adding CPT code E0765 (FDA-approved nerve stimulator for treatment of nausea and vomiting) to the precertification/prior authorization requirement list. This change applies to all PPO and HMO commercial plans in Virginia and requires ordering and servicing providers to obtain prior authorization through Carelon Medical Benefits Management before providing this service.
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What to do
by Feb 1, 2027 · 3 steps
01Billing and clinical staff should implement prior authorization requirements for CPT code E0765 for all Anthem Blue Cross and Blue Shield PPO and HMO plans in Virginia.
02Establish workflow to submit precertification/prior authorization requests to Carelon Medical Benefits Management through their provider portal (https://providerportal.com), Availity Essentials (https://Availity.com), or by contacting MedicalBenefitsManagement.guidelines@Carelon.com.
03Update billing software, encounter forms, and clinical order entry to flag E0765 as requiring prior authorization before claim submission.
If missed: Failure to obtain prior authorization may result in claim denials.
Codes mentioned
E0765
Original notice
[Virginia] Precertification/prior authorization requirement updates — Carelon Medical Benefits Management
providernews.anthem.com · Always check the source before changing claims.
Related changes
See all Anthem BCBS changes →[New York] Precertification/prior authorization requirement updates — Carelon Medical Benefits ManagementMediumEffective Feb 1, 2027 · Provider Bulletin[Ohio] Precertification/prior authorization requirement updates — Carelon Medical Benefits ManagementLowEffective 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