CommercialCoverageMedium impact
Policy Criteria Change
Arkansas Blue Cross Blue Shield·AR · Oncology, Radiology, Radiation Oncology·Medical Policy
Effective date
Apr 1, 2026
We identified it
Jun 19, 2026
Summary
Arkansas Blue Cross updated 11 medical policies primarily affecting radiation therapy and imaging services. Key changes include adding CPT 77423 as non-covered for neutron therapy, expanding breast IMRT coverage, updating PET scan criteria for lymphoma and thyroid cancer, and clarifying that prostate treatment policies exclude metastatic cancer.
Action Required
By April 1, 2026: Billing team must update system to mark CPT 77423 (neutron therapy) as non-covered for Arkansas Blue Cross claims. Review and update prior authorization requirements for PET scans, breast IMRT, and prostate radiation therapy based on new coverage criteria. Providers should review documentation requirements for radiation therapy cases to ensure compliance with updated policy language.