93146 Insurance Policy Changes

CPT 93146 is referenced in 10 tracked payer policy changes from Anthem BCBS and Blue Cross NC. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for CPT 93146 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

High impact
[Ohio] Precertification/prior authorization requirement changes
Anthem BCBS·Effective Sep 1, 2026
Effective September 1, 2026, Anthem will require precertification/prior authorization for 29 new medical codes including diagnostic tests, surgical procedures, and specialized treatments for MyCare Ohio FIDE (Fully Integrated Dual Eligible) members. Services performed without proper authorization may be denied payment.
High impact
Medical Policy Update December 31, 2025
Blue Cross NC·Effective Jan 1, 2026
Blue Cross NC updated multiple medical policies effective January 1, 2026, with extensive billing code changes including new CPT codes for IMRT procedures, archived spine-related policies, updated genetic testing codes, and new skin substitute codes. Most changes involve updating billing systems with new procedure codes while removing outdated ones.
Medium impact
[California] Prior authorization requirement changes
Anthem BCBS·Effective Sep 1, 2026
Anthem Medicare Advantage plans in California will require prior authorization for 27 specific medical codes starting September 1, 2026. These codes cover specialized procedures including neurostimulation, oncology testing, gastric procedures, and fertility treatments.
Medium impact
[California] Prior authorization requirement changes
Anthem BCBS·Effective Sep 1, 2026
Effective September 1, 2026, Anthem will require prior authorization for 13 specific medical codes for Medi-Cal Managed Care members in California, including liver and prostate ablation procedures, spinal decompression, baroreflex activation therapy systems, and specialized injections. Services performed without proper precertification may be denied payment.
High impact
[California] Precertification/prior authorization requirement changes
Anthem BCBS·Effective Sep 1, 2026
Effective September 1, 2026, Anthem will require prior authorization for 25 new medical codes across multiple specialties for Medicare Advantage members in California. These include gastroenterology tests, drug assays, oncology procedures, neurostimulation devices, and various surgical procedures.
Medium impact
[New York] Precertification/prior authorization requirement changes
Anthem BCBS·Effective Sep 1, 2026
Effective September 1, 2026, Anthem will require precertification/prior authorization for 25 new medical codes across multiple specialties including gastroenterology, oncology, neurosurgery, and fertility services for Medicare Advantage members in New York. Services performed without proper prior authorization may be denied payment.
Medium impact
[Ohio] Precertification/prior authorization requirement changes
Anthem BCBS·Effective Sep 1, 2026
Effective September 1, 2026, Anthem will require prior authorization for 24 new medical codes including gastroenterology tests, drug assays, neurostimulation procedures, and various surgical procedures for Medicare Advantage members in Ohio. Claims submitted without proper precertification may be denied payment.
High impact
[Virginia] Prior authorization requirement changes
Anthem BCBS·Effective Sep 1, 2026
Effective September 1, 2026, Anthem will require prior authorization for 28 additional medical codes for Medicare Advantage members in Virginia, including gastroenterology tests, neurostimulation procedures, and fertility treatments. Services performed without obtaining required precertification may be denied for payment.
High impact
[Virginia] Precertification/prior authorization requirement changes
Anthem BCBS·Effective Sep 1, 2026
Effective September 1, 2026, Anthem Medicare Advantage plans will require precertification/prior authorization for 26 specific medical codes including gastroenterology tests, neurostimulation procedures, spinal decompressions, and various specialized treatments. Services performed without proper authorization may be denied payment.
Medium impact
[Georgia] Precertification/prior authorization requirement changes
Anthem BCBS·Effective Sep 1, 2026
Anthem Blue Cross and Blue Shield of Georgia is adding prior authorization requirements for 26 specific medical codes effective September 1, 2026, for Medicare Advantage members only. These codes span multiple specialties including gastroenterology, oncology, neurostimulation procedures, and various surgical interventions.

Related

All billing codes J3590 C9399 J3490 T1015 99214 99205

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