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Medicare AdvantagePrior AuthMedium impact

Hyperbariac Oxygen Therapy

Blue Cross Blue Shield of Rhode Island·RI · Wound Care, Plastic Surgery, Vascular Surgery +2 more·Physician / Facility
Effective date
Oct 1, 2019
We identified it
Jun 20, 2026
Days to comply

Summary

Effective October 1, 2019, Hyperbaric Oxygen Therapy no longer requires prior authorization for BlueCHiP Medicare and commercial products. Services are medically necessary when filed with a covered diagnosis, and the applicable diagnosis must be included on the claim line.

Action Required

Action needed
Immediately: Billing team must update system to remove prior authorization requirements for Hyperbaric Oxygen Therapy claims for BlueCHiP Medicare and commercial products. Ensure all HBO therapy claims include the applicable covered diagnosis on the claim line for proper processing.