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HCBS300 - Medicare Medicaid Coordinated Plan and Blue Cross of Idaho Medicaid Plus Prior Authorizations - Updated services. Care Coordination process changes.
Effective date
Not stated in the notice
Identified
Jun 19, 2026
Summary
Blue Cross of Idaho updated HCBS300 prior authorization requirements for Medicare Medicaid Coordinated Plan (MMCP) and Blue Cross Idaho Medicaid Plus (BCIMP) members, effective December 2023. The policy clarifies that prior authorization must be obtained from the care coordination team before rendering long-term support services (LTSS) and home and community-based services (HCBS). Services rendered without prior authorization will result in claim denials. The policy also specifies that no prior authorization is required for crisis services, but 24-hour notification to Blue Cross of Idaho is mandatory.
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What to do
Action · 7 steps
01IMMEDIATE: Billing team and front-line staff must implement the following.
02Before rendering ANY services to MMCP or BCIMP members, verify that prior authorization has been issued by the care coordination team—check authorization status at providers.bcidaho.com or contact customer service.
03Update all intake and encounter forms to require documentation of prior authorization approval before service delivery.
04Train all billing and clinical staff that services rendered without approved prior authorization will result in claim denials and non-payment.
05For crisis services only: proceed with service delivery but notify Blue Cross of Idaho within 24 hours of service.
06When requesting changes to existing authorizations, contact the member's care coordination team per policy HCBS101.
07Verify that all LTSS and HCBS services listed in the policy (Adult Day Health, Attendant Care, Behavioral Health Day Treatment, Chore Service, Companion Services, Comprehensive Community Support Services, Home Delivered Meals, Homemaker Services, Personal Care Services, Respite Care, Skilled Nursing Services, Specialized Medical Equipment, Supported Employment, etc.) have prior authorization in place before billing.
If missed: Failure to obtain prior authorization will result in claim denials.
Codes mentioned
H0015H2012H2015H2016H2014
Original notice
HCBS300 - Medicare Medicaid Coordinated Plan and Blue Cross of Idaho Medicaid Plus Prior Authorizations - Updated services. Care Coordination process changes.
providers.bcidaho.com · Always check the source before changing claims.
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