What types of policy changes does Excellus BlueCross BlueShield issue?

Excellus BlueCross BlueShield regularly publishes coverage updates including prior authorization requirement changes, billing code additions or deletions, plan-type coverage modifications, and clinical policy revisions. PolicyChanges.app monitors these notices and summarizes the impact for providers.

How often does Excellus BlueCross BlueShield update its policies?

Excellus BlueCross BlueShield typically releases policy bulletins on a rolling basis throughout the year. Our system checks for new updates daily and adds them to this feed as soon as they are identified.

What should I do when Excellus BlueCross BlueShield changes a prior authorization policy?

Review each change's effective date and action-required notes. Update your billing and clinical workflows before the effective date to avoid claim denials. Each policy detail page on PolicyChanges.app includes a plain-English summary and action items.

Excellus BlueCross BlueShield Policy Changes 2026 | Prior Auth & Coverage Updates

Q: How many Excellus BlueCross BlueShield policy changes are tracked here?

This page currently tracks 50 documented Excellus BlueCross BlueShield policy changes. New items are added as they are identified.

Excellus BlueCross BlueShield Policy Changes & Prior Auth Updates

We track 50 documented policy changes from Excellus BlueCross BlueShield across NY. Each entry includes an AI-generated plain-English summary, effective date, affected billing codes, and a direct link to the original Excellus BlueCross BlueShield notice. Use the related links below to narrow results by specialty or state, or sign up for a free daily alert to receive new Excellus BlueCross BlueShield updates automatically.

High impact

Cosmetic and Reconstructive Procedures 7.01.11

Excellus BlueCross BlueShield·Effective Sep 18, 2025

Excellus BlueCross BlueShield updated their cosmetic and reconstructive procedures policy effective September 18, 2025, establishing new detailed criteria for determining when procedures are considered reconstructive (covered) versus cosmetic (not covered). The policy provides specific functional deficit requirements and indication-specific criteria for numerous procedures including breast procedures, chest wall deformity corrections, hyperhidrosis treatments, and various skin procedures.

External Prosthetic Devices - (Effective Date - 2026-08-17) 1.01.18

Orthotics 1.01.25

Orthotics - (Effective Date - 2026-08-17) 1.01.25

Non-Invasive Prenatal Testing - (Effective Date - 2026-08-17) 2.02.25

Transcatheter Heart Valve Procedures 7.01.109

Bariatric and Metabolic Surgery 7.01.29

Positron Emission Tomography (PET) Oncologic Applications 6.01.29

Positron Emission Tomography (PET) - Non-Oncologic Applications 6.01.07

Magnetic Resonance Imaging (MRI) of the Prostate 6.01.46

Neuropsychological and Psychological Testing 3.01.24

Kidney Transplantation 7.02.04

Bone Growth Stimulators 1.01.53

Chimeric Antigen Receptor T-Cell (CAR-T) Therapy for Candidate Selection 7.02.11

Colorectal Cancer Screening and Surveillance 2.01.51

Lumbar Fusion 7.01.117

Molecular Testing of Tumor Tissue to Identify Targeted Therapies for Cancers 2.02.51

Hip Arthroplasty 7.01.96

Surgical Management of Sleep Disorders 7.01.41

Sleep Studies 2.01.28

Platelet Rich Plasma and Growth Factor Treatments 2.01.24

Out-of-Network Services 11.01.13

Continuous Glucose Monitoring Systems/External Insulin Pump Therapy for Diabetes 1.01.30

Therapies (Speech, Physical and Occupational) 8.01.24

Testing for the Use of Biologic Therapeutics for the Treatment of Inflammatory Disorders 2.02.47

Stereotactic Radiosurgery and Stereotactic Body Radiation Therapy 6.01.12

Cardiac Event Monitors 2.01.03

Intraocular Lens (IOL) Implants 9.01.14

Urine Drug Testing 2.02.50

Spinal Cord Stimulation / Dorsal Column Stimulation 7.01.51

Radiofrequency Facet and Sacroiliac Joint Ablation/ Denervation 7.01.42

Percutaneous Vertebroplasty/Mechanical Vertebral Augmentation and Percutaneous Sacroplasty 6.01.17

Osteochondral Grafting of the Knee 7.01.59

Facet Joint Injections/ Medial Branch Blocks 7.01.116

Epidural Steroid Injections 7.01.115

Autologous Chondrocyte Implantation (ACI) 7.01.38

Artificial Cervical Intervertebral Disc 7.01.80

Shoulder Arthroplasty (Total, Partial, Reverse, Revision and Resurfacing) 7.01.95

Sacroiliac Joint Fusion or Stabilization 7.01.93

Metal-on-Metal Total Hip Resurfacing 7.01.74

Lumbar Decompression 7.01.113

Lumbar Microdiscectomy 7.01.98

Intradiscal Procedures 7.01.112

Artificial Lumbar Intervertebral Disc 7.01.63

Cosmetic and Reconstructive Procedures 7.01.11

Thermal Ablation for Solid Tumor Treatment 7.01.111

Durable Medical Equipment Standard and Non-Standard 1.01.00

Wheelchairs and Power Operated Vehicles (POVs) 1.01.16

External Prosthetic Devices 1.01.18

Heart & Heart/Lung Transplant 7.02.06

Chiropractic Care 10.01.02