Traditional MedicareAdministrativeHigh impact
eviCore auths processing update
Blue Cross Blue Shield of Rhode Island·RI·Physician / Facility
Effective date
Jul 14, 2021
We identified it
Jun 19, 2026
Summary
eviCore has updated processing rules for Medicare code change requests effective July 14th. Any changes to approved or denied CPT codes now require creating a completely new authorization case, and providers can no longer edit existing authorizations in their system.
Action Required
Immediately: Billing team and providers must stop attempting to edit existing eviCore authorizations for Medicare patients. When any CPT code changes are needed (additions, deletions, or modifications), create a new authorization case that includes ALL CPT codes - both changed and unchanged codes. Update staff training to reflect that authorization editing is no longer available in the eviCore system.