CommercialPrior AuthMedium impact
Provider Notification March 2025
Blue Cross Blue Shield of Nebraska·NE · Psychiatry, Neurology·Medical Policy
Effective date
Jun 15, 2025
We identified it
Jun 19, 2026
Summary
Blue Cross Blue Shield of Nebraska is updating medical policies for Transcranial Magnetic Stimulation (TMS) and Electroconvulsive Therapy (ECT) to require preauthorization using InterQual criteria. Both procedures will need prior authorization for all claims starting June 15, 2025.
Action Required
Before June 15, 2025: Billing team must update systems to require prior authorization for all TMS and ECT procedures for BCBSNE members. Review InterQual criteria on the BCBSNE Provider Procedures page website. Update encounter forms and EMR templates to remind providers that preauthorization is mandatory. Claims submitted without prior auth after June 15 will be denied.