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CommercialPrior AuthMedium impact

Transurethral Water Vapor Thermal Therapy for Benign Prostatic Hyperplasia

Blue Cross Blue Shield of Rhode Island·RI · Urology·Physician / Facility
Effective date
Jan 1, 2020
We identified it
Jun 20, 2026
Days to comply

Summary

Effective January 1, 2020, transurethral water vapor thermal therapy for benign prostatic hyperplasia is deemed not medically necessary for commercial products, while BlueCHiP for Medicare requires prior authorization. Providers must contact Health Services Management at (401) 272-5670 ext. 3012 or fax to (401) 272-8885 for preauthorization requests.

Action Required

Action needed
Before January 1, 2020: Billing team must update system to flag transurethral water vapor thermal therapy claims - mark as non-covered for commercial plans and require prior authorization for BlueCHiP Medicare patients. Contact (401) 272-5670 ext. 3012 or fax (401) 272-8885 for Medicare preauthorization. Commercial claims will be denied as not medically necessary.