CommercialPrior AuthMedium impact
EyeMed to Manage Prior Authorization for Six New Codes Starting April 2025
Healthfirst·Optometry, Ophthalmology·Prior Authorization
Effective date
Apr 1, 2025
We identified it
Jun 20, 2026
Summary
EyeMed will begin managing prior authorization requirements for six new codes starting April 2025. The billing team will need to obtain prior authorization from EyeMed for these specific procedures before providing services to avoid claim denials.
Action Required
Before April 1, 2025: Billing team must identify the six new codes requiring EyeMed prior authorization by accessing the full policy at the source URL. Update billing system to flag these codes for prior auth requirements. Train staff on EyeMed's prior authorization process. Claims submitted without prior authorization will be denied.