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Prior Approvals

Blue Cross Blue Shield of Vermont·VT·Prior Authorization
Effective date
Aug 1, 2026
We identified it
Jun 19, 2026
Days to comply
42 days

Summary

Blue Cross Vermont has published multiple policy updates affecting prior authorizations, payment processes, and billing requirements with various effective dates throughout 2026-2027. Key changes include new prior approval requirements from routine coding updates, mandatory electronic payments starting October 1, 2026, and updated maternity care coding effective January 1, 2027.

Action Required

Before Aug 1, 2026
By August 1, 2026: Review and implement new Medical Nutrition Therapy and Nutritional Counseling policies. Before October 1, 2026: Enroll in Electronic Fund Transfer (EFT) to avoid payment delays - paper checks will no longer be issued. By July 4, 2026: Complete Third Quarter CAA Provider Directory Validation within 30 days or face claim denials. Before July 3, 2026: Update billing system to include NDC, Unit of Measure, and Quantity for certain services to prevent denials. Before January 1, 2027: Update maternity care coding - global maternity codes will be removed and replaced with new CPT codes.