Medicare AdvantagePrior AuthMedium impact
Transurethral Water Vapor Thermal Therapy and Transurethral Water Jet Ablation (Aquablation) for Benign Prostatic Hyperplasia
Blue Cross Blue Shield of Rhode Island·RI · Urology·Physician / Facility
Effective date
Oct 1, 2021
We identified it
Jun 19, 2026
Summary
Effective October 1, 2021, Transurethral Water Jet Ablation (Aquablation) was added to the policy and will require authorization for Medicare Advantage plans. For commercial products, HCPCS C2596 changed from covered to not medically necessary.
Action Required
By October 1, 2021: Billing team must update system to require prior authorization for Aquablation procedures on Medicare Advantage plans. Update billing software to mark HCPCS C2596 as not medically necessary for commercial products. No changes needed for Medicare Advantage plans regarding C2596 coverage.