CommercialPrior AuthHigh impact
New Prior Authorization Requirement for FEP Blue Basic and FEP Blue Standard Options – Effective Jan. 1
Blue Cross Blue Shield of Kansas·KS · Orthopedics·Prior Authorization
Effective date
Jan 1, 2026
We identified it
Jun 19, 2026
Summary
Starting January 1, 2026, FEP Blue Basic and FEP Blue Standard plans will require prior authorization for elective non-urgent outpatient orthopedic procedures involving the hip, knee, and spine. This extends existing requirements that already apply to FEP Blue Focus members.
Action Required
Before January 1, 2026: Billing team must update prior authorization workflows to include FEP Blue Basic and FEP Blue Standard plans for elective non-urgent outpatient hip, knee, and spine procedures. Update billing system flags and staff training materials. Claims submitted without prior authorization will be subject to medical necessity review and potential denial.