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Anthem BCBSMedicaid · Prior Auth · Provider Bulletin · OH · OncologyMedium impact

[Ohio] Precertification/prior authorization requirement changes

Effective date
Apr 1, 2026
Identified
May 3, 2026

Summary

Effective April 1, 2026, Anthem Medicaid in Ohio will require precertification/prior authorization for CPT code J3391 (Injection, atidarsagene autotemcel, per treatment). Providers must obtain prior authorization before delivering this service or claims will be denied as ineligible for payment.

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What to do

Action · 4 steps
01Before April 1, 2026: Billing team must update billing software and encounter forms to require prior authorization for CPT J3391 for all Ohio Medicaid members.
02Configure system to flag claims for this code and route to prior auth submission process.
03Providers must contact Anthem via Availity Essentials (https://Availity.com), fax (877-643-0672), or phone (800-601-9935) to obtain precertification before service delivery.
04Train front desk and clinical staff to ensure prior authorization is obtained at scheduling.
If missed: Failure to obtain prior authorization will result in claim denials and services being deemed ineligible for payment.

Codes mentioned

J3391

Original notice

[Ohio] Precertification/prior authorization requirement changes
providernews.anthem.com · Always check the source before changing claims.
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Related changes

See all Anthem BCBS changes →
[New York] Precertification/prior authorization requirement changesMediumEffective Apr 1, 2026 · Provider Bulletin[California] Precertification/prior authorization requirement changesMediumEffective Apr 1, 2026 · Provider Bulletin[Virginia] Prior authorization requirement changesMediumEffective Apr 1, 2026 · Provider Bulletin[Virginia] Precertification/prior authorization requirement changesMediumEffective Apr 1, 2026 · Provider BulletinBrowse every Anthem BCBS change in the policy list

Related policy hubs

Anthem BCBS policiesOH policy changesOncologyCode J3391

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