Medicare AdvantagePrior AuthHigh impact
Spine surgery codes will require authorization through eviCore starting February 1, 2023
Blue Cross Blue Shield of Rhode Island·RI · Orthopedics, Neurosurgery·Physician / Facility
Effective date
Feb 1, 2023
We identified it
Jun 19, 2026
Summary
BCBSRI is requiring prior authorization through eviCore for all spine surgery codes effective February 1, 2023, but only for Medicare Advantage members. This expands eviCore's current role beyond radiology and cardiology to include spine surgery authorization management.
Action Required
Before February 1, 2023: Billing team and providers must register for eviCore webinars in January to learn the new authorization process. Update workflow to obtain prior authorization through eviCore portal for all spine surgery procedures for BCBSRI Medicare Advantage patients only. Continue using existing processes for Prospect members and non-Medicare Advantage plans. Download the new Preauthorization Quick Reference Guide from BCBSRI provider portal when available. Failure to obtain prior authorization will result in claim denials.