CommercialPrior AuthMedium impact
MPC November 2023
Blue Cross Blue Shield of Nebraska·NE · Orthopedics, PM&R (Physical Medicine & Rehab), Psychiatry +1 more·Medical Policy
Effective date
Feb 2, 2024
We identified it
Jun 19, 2026
Summary
Blue Cross Blue Shield of Nebraska updated two medical policies effective February 2, 2024. Hip labral reconstruction/augmentation surgery now includes labral augmentation and requires preauthorization. Virtual reality assisted therapies policy expanded to include prescription digital therapeutics (PDTs) like ReSET and Somryst, which are considered experimental and require preauthorization.
Action Required
Before February 2, 2024: Billing team must update prior authorization requirements for hip labral reconstruction/augmentation procedures and virtual reality/prescription digital therapeutic services in billing system. Update encounter forms to remind providers that preauthorization is required for these services. Front desk staff should verify authorization before scheduling. Claims will be denied without proper preauthorization.