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Medicare AdvantagePrior AuthMedium impact

[Georgia] Precertification/prior authorization requirement changes

Anthem BCBS·GA · Gastroenterology, Oncology, Urology +6 more·Provider Bulletin
Effective date
Sep 1, 2026
We identified it
Jun 13, 2026
Days to comply
74 days

Summary

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.

Action Required

Before Sep 1, 2026
Before September 1, 2026: Billing team must update prior authorization system to require precertification for all 26 listed codes (0598U, 0603U, 0609U, 0783T, 0988T, 0989T, 1020T, 43889, 47384, 55877, 62330, 62331, 64654-64659, 64728, 89251, 89253, 89257, 93145, 93146, 95803, J3387, J3389) for Anthem Medicare Advantage members in Georgia. Update encounter forms and EMR alerts to remind providers to obtain prior authorization. Services without proper authorization may be denied payment.

Affected Billing Codes

43889
47384
55877
62330
62331
64654
64655
64656
64657
64658
64659
64728
89251
89253
89257
93145
93146
95803
J3387
J3389